Dental Professionals of Illinois, P.c.
NPI #1053713966 in Machesney Park, Illinois
Provider Information
- NPI Number
- 1053713966
- Entity Type
- Organization
- Organization Name
- Dental Professionals of Illinois, P.c.
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- DENTAL PROFESSIONALS OF ILLINOIS, P.C.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 23, 2014
- Last Updated
- Sep 23, 2014
Practice Location
- Address
- 1411 W LANE RD STE B
- City
- Machesney Park
- State
- Illinois
- ZIP Code
- 61115
- Phone
- (815) 981-9075
Authorized Official
- Name
- LINDSAY BEARDEN
- Title
- CREDENTIALING COORDINATOR
- Phone
- (217) 540-5699
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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