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General NPI Number Information
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NPI Number | 1255759734
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Entity Type | Organization
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Legal Business Name | HAUPERS FAMILY DENTAL LTD.
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Dates
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Enumeration Date | 04/02/2014
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Last Update Date | 04/02/2014
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Provider Practice Location Address
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Address Line | 147 E PALATINE RD
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City | PALATINE
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State | IL
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Zip | 60067-5109
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Country | US
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Telephone | 847-496-9149
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Fax |
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Provider Business Mailing Address
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Address Line | 4361 WILSON AVE
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City | ROLLING MEADOWS
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State | IL
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Zip | 60008-2017
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Country | US
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Telephone | 847-496-9149
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARY HAUPERS
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Credential |
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Telephone | 847-496-9149
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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 |
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