Provider Demographics
NPI:1316268006
Name:SADDLEWOOD FAMILY DENTISTRY P.C.
Entity type:Organization
Organization Name:SADDLEWOOD FAMILY DENTISTRY P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HUDETZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-904-1106
Mailing Address - Street 1:3027 ENGLISH ROW AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5107
Mailing Address - Country:US
Mailing Address - Phone:630-904-1106
Mailing Address - Fax:630-904-5404
Practice Address - Street 1:3027 ENGLISH ROW AVE STE 203
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5107
Practice Address - Country:US
Practice Address - Phone:630-904-1106
Practice Address - Fax:630-904-5404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-017625122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty