Organization
DE LA FUENTE, DMD P.C.
Active
Other names
20/32 DENTAL CO.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISIDRO DE LA FUENTE (BUSINESS MANAGER)
(630) 724-7765
Entity
Organization
Contact information
Practice address
1985 N GARY AVE, WHEATON, IL 60187-3056
(630) 724-7765
Mailing address
125 FORESTVIEW DR, ELGIN, IL 60120-7401
(630) 724-7765
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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