Prairie View Orthodontics
Dentist, Orthodontics and Dentofacial Orthopedics in Aurora, IL. Organization (NPI-2).
NPI number1487796629
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1487796629
- Entity type
- Organization (NPI-2)
- Legal business name
- Prairie View Orthodontics
- Organization subpart
- No
- Enumeration date
- Feb 13, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | 019024237 | IL | Yes |
Practice location
2121 W Galena BlvdAurora, IL 60506-3274
Phone 630-896-5400
Mailing address
2121 W Galena BlvdAurora, IL 60506-3274
Phone 630-896-5400
Authorized official
Jacqueline Lee Pileski Zimmer
Orthodontist
6308965400
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