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Pediatric Dentistry Of Northern Illinois Ltd
Pediatric Dentist in Rockford, Illinois
NPI 1376651679

Pediatric Dentistry Of Northern Illinois Ltd is a Pediatric Dentist based in Rockford, IL and is specialized in Pediatric Dentistry. Pediatric Dentistry Of Northern Illinois Ltd practices in Rockford, IL. The NPI Number for Pediatric Dentistry Of Northern Illinois Ltd is 1376651679 and holds a License No. 019 (Illinois).

The current practice location address for Pediatric Dentistry Of Northern Illinois Ltd is 4903 E State St, Rockford, IL and can be reached out via phone at 815-398-2323 and via fax at 815-398-2328.

Location: 4903 E State St, Rockford, IL, 61108
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1376651679
Provider Name
Pediatric Dentistry Of Northern Illinois Ltd
Credential
Provider Entity Type
Organization
Address
4903 E State St, Rockford, IL, 61108
Phone Number
815-398-2323
Fax Number
815-398-2328
Provider Enumeration Date
08/27/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
4903 E State St
City
Rockford
State
Illinois
Zip
61108
Phone Number
815-398-2323
Fax Number
815-398-2328
person
Provider Business Mailing Address Details
Address
4903 E State St
City
Rockford
State
Illinois
Zip
61108
Phone Number
815-398-2323
Fax Number
815-398-2328
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
019 (Illinois)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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