Organization
KJELD AAMODT DDS MS IL PC
Active
Organization
KJELD AAMODT DDS MS IL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KJELD AAMODT DDS MS (OWNER)
(831) 238-7285
Entity
Organization
Contact information
Practice address
11 E CEDAR ST, CHICAGO, IL 60611
(415) 653-3087
Mailing address
999 SUTTER ST, SAN FRANCISCO, CA 94109-6023
(831) 238-7285
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912250176
—
CA
Enumeration date
01/15/2020
Last updated
01/15/2020
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