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General NPI Number Information
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NPI Number | 1376499509
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Entity Type | Organization
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Legal Business Name | DENTAL CLUB HOFFMAN ESTATES P.C.
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 3381 W MAIN ST STE 3
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City | ST CHARLES
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State | IL
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Zip | 60175-1008
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Country | US
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Telephone | 630-593-7772
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Fax |
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Provider Business Mailing Address
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Address Line | 3N723 JAMES FENIMORE COOPER LN
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City | ST CHARLES
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State | IL
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Zip | 60175-6572
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Country | US
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Telephone | 224-828-0400
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Fax |
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Authorized Official
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Title or Position | CEIF OPERATIONS OFFICER
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Name | MR. JOHN SELLERS
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Credential |
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Telephone | 224-838-0400
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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 |
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License Number State |
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