Organization
MCHENRY DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY WOLTER (INSURANCE MANAGER)
(630) 869-5857
Entity
Organization
Contact information
Practice address
1315 N RIVERSIDE DR, MCHENRY, IL 60050-4509
(815) 385-1360
Mailing address
1699 E WOODFIELD RD STE 102, SCHAUMBURG, IL 60173-4955
(630) 339-3172
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019021569
IL
Other
Enumeration date
06/13/2018
Last updated
06/13/2018
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