Organization
EARL E WOELTJE JR
Active
Parent organization
-
Organization subpart
Yes
Provider details
NPI number
Legal business name
-
Authorized official
DR. EARL ERNST WOELTJE JR. DDS (OWNER)
(815) 672-2195
Entity
Organization
Contact information
Practice address
712 N BLOOMINGTON ST, STREATOR, IL 61364-2087
(815) 672-2195
Mailing address
PO BOX 516, STREATOR, IL 61364-0516
(815) 672-2195
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
12/06/2017
Last updated
11/15/2023
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