Healthcare Provider Details

I. General information

NPI: 1558028811
Provider Name (Legal Business Name): MJDDDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 BOOK RD STE 107
NAPERVILLE IL
60564-9546
US

IV. Provider business mailing address

3155 BOOK RD STE 107
NAPERVILLE IL
60564-9546
US

V. Phone/Fax

Practice location:
  • Phone: 630-922-1311
  • Fax: 630-922-4212
Mailing address:
  • Phone: 630-922-1311
  • Fax: 630-922-4212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW J DRESCHER
Title or Position: OWNER
Credential: D.D.S
Phone: 630-922-1311