Organization
KLOBERDANZ ORAL SURGERY AND DENTAL IMPLANTS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN KLOBERDANZ D.D.S. (PRESIDENT)
(630) 377-7077
Entity
Organization
Contact information
Practice address
2580 FOXFIELD RD STE 100, ST CHARLES, IL 60174-1411
(630) 377-7077
Mailing address
2580 FOXFIELD RD STE 100, ST CHARLES, IL 60174-1411
(630) 377-7077
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
021001535
IL
Other
Enumeration date
09/15/2015
Last updated
09/15/2015
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