Organization
HANSON & SEVANDAL DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAUREEN SEVANDAL DDS (MEMBER)
(312) 493-6102
Entity
Organization
Contact information
Practice address
2570 FOXFIELD RD STE 203, ST CHARLES, IL 60174-1406
(630) 587-4444
(630) 587-5811
Mailing address
2570 FOXFIELD RD STE 203, ST CHARLES, IL 60174-1406
(630) 587-4444
(630) 587-5811
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019.026706
IL
1223P0221X
Pediatric Dentistry
019026649
IL
Other
Enumeration date
04/08/2014
Last updated
04/08/2014
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