Provider Demographics
NPI:1518972314
Name:ASUAN, SENEN RAMON V (DDS)
Entity Type:Individual
Prefix:
First Name:SENEN RAMON
Middle Name:V
Last Name:ASUAN
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 1:1424 S BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-9424
Mailing Address - Country:US
Mailing Address - Phone:847-247-0600
Mailing Address - Fax:847-247-9218
Practice Address - Street 1:1424 S BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-9424
Practice Address - Country:US
Practice Address - Phone:847-247-0600
Practice Address - Fax:847-247-9218
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0238711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice