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General NPI Number Information
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NPI Number | 1659545762
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Entity Type | Organization
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Legal Business Name | COUNTY OF MCHENRY
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 237 MAIN STREET
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City | WOODSTOCK
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State | IL
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Zip | 60098
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Country | US
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Telephone | 815-337-5616
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Fax | 815-337-5624
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Provider Business Mailing Address
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Address Line | 237 MAIN STREET
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City | WOODSTOCK
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State | IL
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Zip | 60098
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Country | US
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Telephone | 815-337-5616
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Fax | 815-337-5624
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Authorized Official
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Title or Position | DENTAL COORDINATOR
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Name | ROSA D. BELLIDO-GRIFFIN
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Credential | D.M.D.
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Telephone | 815-337-5616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State | IL
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