Organization
DETTMER & BAUER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN A DETTMER DDS (PRESIDENT)
16306655550
Entity
Organization
Contact information
Practice address
531 E ROOSEVELT RD, SUITE 100, WHEATON, IL 60187-5583
(630) 665-5550
(630) 665-5554
Mailing address
531 E ROOSEVELT RD, SUITE 100, WHEATON, IL 60187-5583
(630) 665-5550
(630) 665-5554
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019.014036
IL
Other
Enumeration date
08/07/2010
Last updated
08/07/2010
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