Jenna Nicole Polacek, D.D.S.
Dentist, General Practice in Aurora, IL. Individual provider (NPI-1).
NPI number1790171007
StatusActive
Last updated in NPPESJul 13, 2016
Details
- NPI
- 1790171007
- Entity type
- Individual (NPI-1)
- Name
- Jenna Nicole Polacek
- Credential
- D.D.S.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 13, 2015
- Last updated
- Jul 13, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 019030616 | IL | Yes |
Practice location
2211 S Eola Rd Ste DAurora, IL 60503-6485
Phone 630-851-5250
Mailing address
2211 S Eola Rd Ste DAurora, IL 60503-6485
Fax 708-216-5560
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