Kelly Anne Mack, RD4
Dental Hygienist in Wheaton, IL. Individual provider (NPI-1).
NPI number1245308899
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1245308899
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kelly Anne Mack
- Credential
- RD4
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 1, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 124Q00000X | Dental Hygienist | 020008841 | IL | Yes |
Practice location
55 E Loop RdGrove Dental Assoc Suite 201
Wheaton, IL 60187
Phone 630-653-8899
Mailing address
621 Glacier TrailRoselle, IL 60172
Phone 630-980-0992
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Other Dental Hygienist providers in Wheaton, IL
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- Andrea Nichole Trattner, RDHNPI 1578631107
- Dori Jean Wachowski, RDHNPI 1639247265
All 8 Dental Hygienist providers in Wheaton · All 2,946 providers in Wheaton
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