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General NPI Number Information
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NPI Number | 1811063662
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Entity Type | Organization
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Legal Business Name | GENTLE FAMILY DENTISTY OF NAPERVILLE
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10 E BENTON AVE
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City | NAPERVILLE
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State | IL
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Zip | 60540
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Country | US
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Telephone | 630-355-0100
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Fax | 630-355-0572
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Provider Business Mailing Address
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Address Line | 10 E BENTON AVE
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City | NAPERVILLE
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State | IL
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Zip | 60540
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Country | US
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Telephone | 630-355-0100
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Fax | 630-355-0572
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN A JAESCHKE
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Credential | DDS
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Telephone | 630-355-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State | IL
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