Daniel B Fuertges, DDS
Individual provider Active NPI General Practice Dentistry · Walnut, IL
NPI 1508069717 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1508069717
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Practice address
- 101 N Main St
Walnut, IL 61376-0624 - Phone
- (815) 379-9012
- Fax
- (815) 379-2762
- NPI assigned
- Jun 6, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019013121 | IL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Yes |
Addresses
Primary practice location
101 N Main St
Walnut, IL 61376-0624
Mailing address
PO Box 624
101 N Main St
Walnut, IL 61376-0624
Phone (815) 379-9012
Other providers in Walnut, IL
- Allure of Walnut , LLC
- Allure of Walnut , LLC
- Dean a. Hulsing PC
- Katie C Edwards
- Carolyn Jean Gale
- Linda L Grant
- Heritage Manor - Walnut, LLC
- Heritage Manor - Walnut, LLC
- Dean A Hulsing
All providers in Walnut, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.