Organization
WHEATON PRAIRIE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN J ACIERNO DDS (MANAGER)
(630) 339-3172
Entity
Organization
Contact information
Practice address
610 W ROOSEVELT RD, SUITE A1, WHEATON, IL 60187-5087
(630) 339-3172
Mailing address
129 S ROSELLE RD, SUITE 102, SCHAUMBURG, IL 60193-5540
(630) 339-3172
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
019015107
IL
305R00000X
Preferred Provider Organization
019029436
IL
Other
Enumeration date
04/26/2016
Last updated
04/26/2016
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