Organization
NORTHBROOK DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY W RODGERS DDS (CEO)
(312) 420-3614
Entity
Organization
Contact information
Practice address
1135 CHURCH ST, NORTHBROOK, IL 60062
(847) 205-9337
Mailing address
1135 CHURCH ST, NORTHBROOK, IL 60062-3601
(847) 205-9337
(847) 972-6439
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019026122
IL
Other
Enumeration date
02/16/2012
Last updated
06/12/2018
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