Organization
NEW AVENUE DENTAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN HUGHES (OFFICE MANAGER)
(815) 210-3030
Entity
Organization
Contact information
Practice address
7546 JANES AVE, WOODRIDGE, IL 60517-2926
(630) 985-9787
Mailing address
22548 N PEBBLE LAKE CT, FRANKFORT, IL 60423-8975
(815) 210-3030
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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