Access Dental of Peoria Optim LLC

NPI #1437818242 in Peoria, Illinois

Provider Information

NPI Number: 1437818242
Entity Type: Organization
Organization Name: Access Dental of Peoria Optim LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 9, 2021
Last Updated: Dec 9, 2021

Practice Location

Address: 1200 W MAIN ST STE 9
City: Peoria
State: Illinois
ZIP Code: 61606-1218
Phone: (309) 777-9777

Authorized Official

Name: ANDREA CARRILLO
Title: REGIONAL MANAGER
Phone: (512) 351-2612

Specialties & Taxonomy Codes

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

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