Organization
CROSSROADS DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER P KOCH DMD (OWNER)
(708) 444-2273
Entity
Organization
Contact information
Practice address
9532 179TH ST, TINLEY PARK, IL 60477-9602
(708) 444-2273
(708) 444-7380
Mailing address
9532 179TH ST, TINLEY PARK, IL 60477-9602
(708) 444-2273
(708) 444-7380
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/25/2007
Last updated
07/18/2007
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