Andronova, Ksenia

Andronova, Ksenia is an sole proprietor health care provider with primary practice located at 275 N Phelps Ave , Rockford IL 61108-2434. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Andronova, Ksenia can be contacted via phone (815) 484-8678.

Contact Information

Primary practice address
275 N Phelps Ave Rockford IL 61108-2434
Phone: (815) 484-8678
Fax: (815) 484-8680
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X Illinois

Profile Details

NPI number 1801948443
LBN Legal business name Andronova, Ksenia
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 16th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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