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General NPI Number Information
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NPI Number | 1003690496
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Entity Type | Organization
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Legal Business Name | DYER DENTISTRY SERVICES
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Dates
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Enumeration Date | 08/24/2023
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 20505 N RAND RD STE 244
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City | KILDEER
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State | IL
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Zip | 60047-3004
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Country | US
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Telephone | 847-796-0789
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 SAVANNAH CIR
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City | MUNDELEIN
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State | IL
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Zip | 60060-1637
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Country | US
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Telephone | 319-215-5876
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMANDA DYER
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Credential | DDS
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Telephone | 319-215-5876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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