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Hentscher-Johnson Orthodontics

Dentist in Waterloo, IL. Organization (NPI-2).

NPI number1750648564
StatusActive
Last updated in NPPESApr 18, 2012

Details

NPI
1750648564
Entity type
Organization (NPI-2)
Legal business name
Hentscher-Johnson Orthodontics
Organization subpart
No
Enumeration date
Apr 18, 2012
Last updated
Apr 18, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist019.028038ILYes

Practice location

200 E Mill St
Waterloo, IL 62298-1519

Phone 618-939-2900 · Fax 888-908-5295

Mailing address

200 E Mill St
Waterloo, IL 62298-1519

Phone 618-939-2900 · Fax 888-908-5295

Authorized official

Jodi Kay Hentscher-Johnson
Dentist/Orthodontist
6189392900

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