Organization
MAIN STREET SQUARE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT PETERSON DMD (MEMBER)
(847) 624-6700
Entity
Organization
Contact information
Practice address
2932 FINLEY RD, DOWNERS GROVE, IL 60515-1042
(630) 629-6299
Mailing address
1644 BARKEI DR, BATAVIA, IL 60510-8304
(847) 624-6700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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