Organization
FREDERICK P WALDSCHMIDT D D S P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK P WALDSCHMIDT DDS (PRESIDENT SECRETARY TREASURER)
(815) 932-5221
Entity
Organization
Contact information
Practice address
750 ALMAR PARKWAY, SUITE 101, BOURBONNAIS, IL 60914
(815) 932-5221
(815) 932-5269
Mailing address
750 ALMAR PARKWAY, SUITE 101, BOURBONNAIS, IL 60914
(815) 932-5221
(815) 932-5269
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019019355
IL
Other
Enumeration date
11/17/2006
Last updated
04/21/2015
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