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General NPI Number Information
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NPI Number | 1568636686
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Entity Type | Organization
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Legal Business Name | MARIO F. RINCON, DDS, PC
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 157 S LINCOLN AVE STE B
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City | AURORA
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State | IL
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Zip | 60505-4264
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Country | US
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Telephone | 630-844-0550
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Fax | 630-892-7967
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Provider Business Mailing Address
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Address Line | 157 S LINCOLN AVE STE B
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City | AURORA
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State | IL
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Zip | 60505-4264
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Country | US
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Telephone | 630-844-0550
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Fax | 630-892-7967
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. MARIO F. RINCON
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Credential | D.D.S.
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Telephone | 630-892-7967
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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 | IL
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