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General NPI Number Information
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NPI Number | 1497019301
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Entity Type | Organization
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Legal Business Name | WESTMONT DENTAL SALON, P.C.
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 06/26/2012
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Provider Practice Location Address
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Address Line | 519 N CASS AVE SUITE 1E
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City | WESTMONT
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State | IL
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Zip | 60559-1514
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Country | US
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Telephone | 630-515-1414
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Fax | 630-515-9729
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Provider Business Mailing Address
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Address Line | 519 N CASS AVE SUITE 1E
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City | WESTMONT
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State | IL
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Zip | 60559-1514
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Country | US
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Telephone | 630-515-1414
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Fax | 630-515-9729
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. WESLEY ERIC CAMPIN
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Credential | DDS
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Telephone | 630-515-1414
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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 | 019-026141
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License Number State | IL
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