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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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