Prairie View Dental LLC

NPI #1063570752 in Sycamore, Illinois

Provider Information

NPI Number: 1063570752
Entity Type: Organization
Organization Name: Prairie View Dental LLC
Primary Specialty: Dentist
Enumeration Date: Dec 5, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 115 W PEACE RD
City: Sycamore
State: Illinois
ZIP Code: 60178
Phone: (815) 895-6100

Authorized Official

Name: DR. TIFFANY K JOZWIAK
Title: DENTIST OWNER
Phone: (815) 895-6100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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