ST. CHARLES MODERN DENTAL LLC NPI 1912220773

NPI Information

ST. CHARLES MODERN DENTAL, LLC is a general practice dentist in St Charles, IL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. ST. CHARLES MODERN DENTAL, LLC NPI is 1912220773. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is St. Charles Modern Dental.

The provider's business location address is:

855 S RANDALL RD
ST CHARLES, IL
ZIP 60174-570
Phone: (630) 587-2700
Fax: (630) 405-1738

The provider's authorized official is Kianor Shahmohmmadi .
The authorized official title is Ceo - Nexus Dentistry and has the following contact phone number (618) 917-5808.

The enumeration date for this NPI number is 3/9/2010 and was last updated on 3/9/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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