Organization
MAIN STREET DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN M. ACIERNO DDS (CHIEF FINANCIAL OFFICER)
(630) 339-3172
Entity
Organization
Contact information
Practice address
801 MAIN STREET NW, BOURBONNAIS, IL 60914
(815) 932-3516
Mailing address
129 S. ROSELLE RD, STE. 102, SCHAUMBURG, IL 60193
(630) 339-3172
(847) 891-6775
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
07/17/2015
Last updated
09/15/2015
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