Organization
ANTIOCH DENTAL CENTRE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH ARTHUR JOHNSON DDS (PRESIDENT)
(847) 395-3250
Entity
Organization
Contact information
Practice address
439 LAKE ST, ANTIOCH, IL 60002-1405
(847) 395-3250
Mailing address
439 LAKE ST, ANTIOCH, IL 60002-1405
(847) 395-3250
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/16/2024
Last updated
03/07/2024
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