Organization
PRECISION ENDODONTICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FERNANDO REY URZUA D.D.S. (PRESIDENT)
(630) 469-4500
Entity
Organization
Contact information
Practice address
215 REMINGTON BLVD, BOLINGBROOK, IL 60440-3656
(630) 469-4500
Mailing address
215 REMINGTON BLVD, BOLINGBROOK, IL 60440-3656
(630) 469-4500
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
021002327
IL
305R00000X
Preferred Provider Organization
Primary
021002327
IL
Other
Enumeration date
10/13/2010
Last updated
10/13/2010
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