| NPI | 1417581893 |
|---|---|
| Former Legal Business Name | DR SCOTT BERDELLE DDS PC |
| Entity Type | Organization |
| Authorized Contact | SCOTT EDWARD BERDELLE Dentist 847-885-4343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-27 |