Provider Demographics
NPI:1720150097
Name:MCDOWELL, DENNIS JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:JAMES
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 N IL ROUTE 31
Mailing Address - Street 2:SUITE E
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60012-3790
Mailing Address - Country:US
Mailing Address - Phone:815-455-6120
Mailing Address - Fax:815-455-7024
Practice Address - Street 1:690 N IL ROUTE 31
Practice Address - Street 2:SUITE E
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60012-3790
Practice Address - Country:US
Practice Address - Phone:815-455-6120
Practice Address - Fax:815-455-7024
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist