Organization
ORAL AND MAXILLO FACIAL SURGEONS FOR NORTHERN ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD M ANDERSON DDS (PRESIDENT)
(815) 595-3000
Entity
Organization
Contact information
Practice address
1675 BETHANY RD, SUITE A, SYCAMORE, IL 60178
(815) 895-3000
(815) 895-0505
Mailing address
1675 BETHANY RD, SUITE A, SYCAMORE, IL 60178
(815) 895-3000
(815) 895-0505
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
08/15/2007
Last updated
07/19/2019
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