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Organization

QUINTESSENTIAL DENTAL

Active
Other names
Happy Tooth
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MAGGIE W AUGUSTYN DDS (DENTIST/PRESIDENT)
(630) 834-4140
Entity
Organization

Contact information

Practice address
130 N ADDISON AVE, ELMHURST, IL 60126
(630) 834-4140
Mailing address
130 ADDISON AVE, ELMHURST, IL 60126
(630) 834-4141
(630) 834-4577

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9185625
IL
05
9815623
IL
Enumeration date
04/18/2008
Last updated
04/18/2008
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