Organization
GREAT SMILES OF ROCKFORD, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN NABONG ABIERA DMD (PRESIDENT)
(815) 395-1600
Entity
Organization
Contact information
Practice address
780 N MULFORD RD, ROCKFORD, IL 61107-3855
(815) 395-1600
(815) 399-0614
Mailing address
780 N MULFORD RD, ROCKFORD, IL 61107-3855
(815) 395-1600
(815) 399-0614
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
04/19/2007
Last updated
09/27/2007
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