Organization
APPLEWHITE DENTAL ILLINOIS, P.C.
Active
Parent organization
APPLEWHITE DENTAL ILLINOIS, P.C.
Other names
Connection 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
2661 W STEPHENSON ST, FREEPORT, IL 61032-4502
(563) 582-1448
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
08/10/2018
Last updated
07/29/2019
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