Fieldcrest Dental, P.c.

NPI #1275879918 in Toluca, Illinois

Provider Information

NPI Number: 1275879918
Entity Type: Organization
Organization Name: Fieldcrest Dental, P.c.
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 28, 2012
Last Updated: Dec 28, 2012

Practice Location

Address: 203 E SANTA FE AVE
City: Toluca
State: Illinois
ZIP Code: 61369
Phone: (815) 452-2513

Authorized Official

Name: DR. PATRICK HAMPER
Title: SHAREHOLDER
Phone: (815) 452-2513

Specialties & Taxonomy Codes

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

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