Organization
APPLEWHITE DENTAL ILLINOIS, P.C.
Active
Parent organization
APPLEWHITE DENTAL ILLINOIS, P.C.
Other names
Sauk Valley Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
APPLEWHITE DENTAL ILLINOIS, P.C.
Authorized official
SHARON L LOSO (CREDENTIALING SPECIALIST)
(563) 582-1448
Entity
Organization
Contact information
Practice address
654 REYNOLDSWOOD RD, DIXON, IL 61021-9108
(815) 288-4028
(815) 622-4028
Mailing address
40 MAIN ST STE 100, DUBUQUE, IA 52001-7654
(563) 582-1448
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/26/2019
Last updated
07/29/2019
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