Organization
KEITH W. JAESCHKE D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH W JAESCHKE D.D.S. (PRESIDENT)
(815) 942-0182
Entity
Organization
Contact information
Practice address
1545 CREEK DR, MORRIS, IL 60450-6857
(815) 942-0182
Mailing address
1545 CREEK DR, P.O. BOX 745, MORRIS, IL 60450-6857
(815) 942-0182
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
07/22/2006
Last updated
08/22/2020
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