Applewhite Dental Illinois, P.C.
Dentist, General Practice in Dixon, IL. Organization (NPI-2).
NPI number1972157154
StatusActive
Last updated in NPPESJul 29, 2019
Details
- NPI
- 1972157154
- Entity type
- Organization (NPI-2)
- Legal business name
- Applewhite Dental Illinois, P.C.
- Organization subpart
- Yes
- Enumeration date
- Jul 26, 2019
- Last updated
- Jul 29, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 122300000X | Dentist | – | – |
Other names
- Sauk Valley Dental (Doing Business As)
Practice location
654 Reynoldswood RdDixon, IL 61021-9108
Phone 815-288-4028 · Fax 815-622-4028
Mailing address
40 Main St Ste 100Dubuque, IA 52001-7654
Phone 563-582-1448
Authorized official
Sharon L Loso
Credentialing Specialist
5635821448
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