Lifetime Dental Care of Maryland, Badger, P.c.

NPI #1093140501 in Effingham, Illinois

Provider Information

NPI Number
1093140501
Entity Type
Organization
Organization Name
Lifetime Dental Care of Maryland, Badger, P.c.
Subpart
Yes (part of a larger organization)
Parent Organization
DENTAL PROFESSIONALS OF MARYLAND, GERALD AWADZI, PC
Primary Specialty
Dentist - General Practice
Enumeration Date
Sep 4, 2013
Last Updated
Aug 13, 2019

Practice Location

Address
1200 NETWORK CENTRE DRIVE
Address 2
SUITE #2
ZIP Code
62401
Phone
(217) 540-8946

Authorized Official

Name
BRITTANY NICHELLE HOWARD
Title
CREDENTIALING AFFILIATION COORDINAT
Phone
(217) 540-8946

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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