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General NPI Number Information
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NPI Number | 1316268006
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Entity Type | Organization
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Legal Business Name | SADDLEWOOD FAMILY DENTISTRY P.C.
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Dates
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Enumeration Date | 06/16/2010
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Last Update Date | 06/16/2010
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Provider Practice Location Address
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Address Line | 3027 ENGLISH ROW AVE STE 203
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City | NAPERVILLE
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State | IL
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Zip | 60564-5107
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Country | US
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Telephone | 630-904-1106
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Fax | 630-904-5404
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Provider Business Mailing Address
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Address Line | 3027 ENGLISH ROW AVE STE 203
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City | NAPERVILLE
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State | IL
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Zip | 60564-5107
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Country | US
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Telephone | 630-904-1106
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Fax | 630-904-5404
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. PATRICIA K HUDETZ
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Credential | D.D.S.
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Telephone | 630-904-1106
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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 | 019-017625
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License Number State | IL
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