Organization
SMD ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSMAR RODRIGUEZ D.D.S. (PRESIDENT/DENTIST)
(847) 531-5250
Entity
Organization
Contact information
Practice address
300 S MCLEAN BLVD STE M, ELGIN, IL 60123-1023
(847) 531-5250
(847) 531-5270
Mailing address
300 S MCLEAN BLVD STE M, ELGIN, IL 60123-1023
(847) 531-5250
(847) 531-5270
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021001216
IL
302F00000X
Exclusive Provider Organization
021001216
IL
Other
Enumeration date
09/24/2009
Last updated
09/24/2009
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