Organization
MAIN SQUARE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTHA MULDOWNEY (DR)
(815) 623-9292
Entity
Organization
Contact information
Practice address
5392 WILLIAMS DR, ROSCOE, IL 61073-7320
(815) 623-9292
Mailing address
5392 WILLIAMS DR, ROSCOE, IL 61073-7320
(815) 623-9292
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19016896
IL
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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