Organization
HENTSCHER-JOHNSON ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JODI KAY HENTSCHER-JOHNSON D.M.D., M.S. (DENTIST/ORTHODONTIST)
(618) 939-2900
Entity
Organization
Contact information
Practice address
200 E MILL ST, WATERLOO, IL 62298-1519
(618) 939-2900
(888) 908-5295
Mailing address
200 E MILL ST, WATERLOO, IL 62298-1519
(618) 939-2900
(888) 908-5295
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.028038
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942577234
TYPE 1 NPI
IL
Enumeration date
04/18/2012
Last updated
04/18/2012
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