Anna De La Fuente Dmd PC
Dentist, General Practice in Wheeling, IL. Organization (NPI-2).
NPI number1487000535
StatusActive
Last updated in NPPESMay 13, 2016
Details
- NPI
- 1487000535
- Entity type
- Organization (NPI-2)
- Legal business name
- Anna De La Fuente Dmd PC
- Organization subpart
- No
- Enumeration date
- May 9, 2016
- Last updated
- May 13, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 019.030345 | IL | Yes |
Practice location
282 Mchenry RdWheeling, IL 60090-3202
Phone 847-235-6859 · Fax 847-235-6958
Mailing address
4111 W Annbriar DrPeoria, IL 61615-9487
Authorized official
Anna De La Fuente
President
6305640096
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