Organization
DENTAL CLUB ST. CHARLES P.C.
Active
Other names
Dental Club St. Charles
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS J RYAN JR. DDS (PRESIDENT)
(708) 305-0729
Entity
Organization
Contact information
Practice address
3381 W MAIN ST STE 3, ST CHARLES, IL 60175-1008
(630) 513-2121
Mailing address
11310 POPLAR CREEK LN, ORLAND PARK, IL 60467-7308
(708) 305-0729
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/20/2022
Last updated
07/20/2022
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