Organization
205 DIRECT DENTAL SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY CYRUS OATES DDS (DENTIST / PRESIDENT)
(815) 637-6400
Entity
Organization
Contact information
Practice address
4151 SAMUELSON RD, ROCKFORD, IL 61109-3272
(815) 637-6400
Mailing address
3957 N MULFORD RD, ROCKFORD, IL 61114-8004
(815) 637-6400
(815) 637-6477
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/10/2025
Last updated
09/10/2025
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