Organization
MARTIN A. DETTMER, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN A DETTMER DDS (OWNER)
(630) 665-5550
Entity
Organization
Contact information
Practice address
531 E ROOSEVELT RD, STE. 100, WHEATON, IL 60187-5583
(630) 665-5550
Mailing address
531 E ROOSEVELT RD, STE. 100, WHEATON, IL 60187-5583
(630) 665-5550
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
19A14036
IL
Other
Enumeration date
04/27/2008
Last updated
04/27/2008
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