Organization
AUSTRIACO DENTAL ASSOCIATES LLC
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME AUSTRIACO DDS (OWNER)
(866) 273-8204
Entity
Organization
Contact information
Practice address
7310 WALTON ST STE A, ROCKFORD, IL 61108-4614
(866) 273-8204
(866) 803-4943
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(866) 273-8204
(866) 803-4943
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019021311
IL
Other
Enumeration date
04/03/2013
Last updated
04/03/2013
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