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Organization

25 EAST DENTAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALAN J ACIERNO DDS (MANAGER)
(630) 339-3172
Entity
Organization

Contact information

Practice address
25 E WASHINGTON ST, SUITE 1115, CHICAGO, IL 60602-1708
(630) 339-3172
Mailing address
129 S ROSELLE RD, SUITE 102, SCHAUMBURG, IL 60193-5540
(630) 339-3172

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
019018378
IL

Other

Enumeration date
08/24/2016
Last updated
08/24/2016
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