Organization
DENTAL BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC EDWARD KLEIN DMD (OWNER)
(815) 806-1451
Entity
Organization
Contact information
Practice address
20646 ABBEY WOODS COURT NORTH, SUITE 101, FRANKFORT, IL 60423-3169
(815) 806-1451
(815) 806-1454
Mailing address
20646 ABBEY WOODS COURT NORTH, SUITE 101, FRANKFORT, IL 60423-3169
(815) 806-1451
(815) 806-1454
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
05/31/2007
Last updated
08/22/2020
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