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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