Organization
JENNY BARUCH DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNY KWON BARUCH DDS (DENTIST)
(815) 477-2369
Entity
Organization
Contact information
Practice address
805 S MCHENRY AVE, STE 1, CRYSTAL LAKE, IL 60014-7450
(815) 477-2369
Mailing address
805 S MCHENRY AVE, STE 1, CRYSTAL LAKE, IL 60014-7450
(815) 477-2369
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
019028247
IL
Other
Enumeration date
06/03/2010
Last updated
03/02/2012
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