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General NPI Number Information
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NPI Number | 1144526948
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Entity Type | Individual
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Provider Name | DAVID D JANES D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 01/27/2011
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Provider Practice Location Address
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Address Line | 210 N MADISON ST
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City | WOODSTOCK
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State | IL
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Zip | 60098-3450
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Country | US
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Telephone | 815-338-7569
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Fax | 815-338-1070
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Provider Business Mailing Address
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Address Line | 210 N MADISON ST
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City | WOODSTOCK
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State | IL
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Zip | 60098-3450
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Country | US
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Telephone | 815-338-7569
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Fax | 815-338-1070
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019015666
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License Number State | IL
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