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General NPI Number Information
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NPI Number | 1013025444
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Entity Type | Individual
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Provider Name | ELAINE WAITE PIEDRA D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 127 W AURORA AVE
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City | NAPERVILLE
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State | IL
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Zip | 60540-6503
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Country | US
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Telephone | 630-579-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 106 N COLUMBIA ST
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City | NAPERVILLE
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State | IL
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Zip | 60540-4714
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Country | US
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Telephone | 630-579-6000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | IL
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