Organization
UDELSON ELMHURST LLC
Active
Other names
Elmhurst Dentistry for Kids
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY UDELSON DDS (OWNER)
(630) 833-1166
Entity
Organization
Contact information
Practice address
323 N YORK ST, ELMHURST, IL 60126-2319
(630) 833-1166
Mailing address
323 N YORK ST, ELMHURST, IL 60126-2319
(630) 833-1166
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
021001495
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021001495
PEDIATRIC DENTISTRY
IL
Enumeration date
10/24/2017
Last updated
07/17/2024
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