32drs Family Dental 2, LLC
Dentist, General Practice in Rockford, IL. Organization (NPI-2).
NPI number1003537010
StatusActive
Last updated in NPPESSep 7, 2022
Details
- NPI
- 1003537010
- Entity type
- Organization (NPI-2)
- Legal business name
- 32drs Family Dental 2, LLC
- Organization subpart
- No
- Enumeration date
- Sep 7, 2022
- Certification date
- Sep 7, 2022
- Last updated
- Sep 7, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
5876 E State StRockford, IL 61108-2428
Phone 847-250-7784
Mailing address
5876 E State StRockford, IL 61108-2428
Authorized official
Jacob Philip
Owner
8472507784
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