Organization
A DENTAL PLACE LTD
Active
Other names
A Dental Place LTD.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAN FONG DDS (OWNER)
(630) 620-7300
Entity
Organization
Contact information
Practice address
845 S MAIN ST, SUITE 202, LOMBARD, IL 60148-3350
(630) 620-7300
(630) 620-7352
Mailing address
845 S MAIN ST, SUITE 202, LOMBARD, IL 60148-3350
(630) 620-7300
(630) 620-7352
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19020812
IL
Other
Enumeration date
03/22/2012
Last updated
03/22/2012
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