Organization
ANNA DE LA FUENTE DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNA DE LA FUENTE DMD (PRESIDENT)
(630) 564-0096
Entity
Organization
Contact information
Practice address
282 MCHENRY RD, WHEELING, IL 60090-3202
(847) 235-6859
(847) 235-6958
Mailing address
4111 W ANNBRIAR DR, PEORIA, IL 61615-9487
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.030345
IL
Other
Enumeration date
05/09/2016
Last updated
05/13/2016
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