Dental Professionals of Illinois, P.c.

NPI #1225250590 in Peoria, Illinois

Provider Information

NPI Number: 1225250590
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: May 3, 2007
Last Updated: Jan 8, 2014

Practice Location

Address: 6808 N. KNOXVILLE AVENUE
City: Peoria
State: Illinois
ZIP Code: 61614
Phone: (309) 691-8558

Authorized Official

Name: LINDSAY BEARDEN
Title: INS COOD
Phone: (217) 540-5100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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