Organization
FOX RIVER DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUBBASHINI MARIMUTHU D.M.D (PRESIDENT)
(630) 554-9900
Entity
Organization
Contact information
Practice address
2968 ROUTE 34, OSWEGO, IL 60543
(630) 554-9909
(630) 554-9909
Mailing address
2968 ROUTE 34, OSWEGO, IL 60543
(630) 554-9909
(630) 554-9909
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019026849
IL
Other
Enumeration date
10/07/2008
Last updated
10/10/2016
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