Michael Connolly

NPI #1487921490 in East Peoria, Illinois

Provider Information

NPI Number: 1487921490
Entity Type: Individual
Name: Michael Connolly
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: Nov 18, 2011
Last Updated: Nov 18, 2011

Practice Location

Address: 1001 ILLINI DR
City: East Peoria
State: Illinois
ZIP Code: 61611-1883
Phone: (309) 694-2620

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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