Prairie Dental Associates, P.c.

NPI #1528253994 in Bloomington, Illinois

Provider Information

NPI Number
1528253994
Entity Type
Organization
Organization Name
Prairie Dental Associates, P.c.
Primary Specialty
Dentist - General Practice
Enumeration Date
Sep 10, 2007
Last Updated
Sep 10, 2007

Practice Location

Address
3220 GERIG DR
ZIP Code
61704-6394
Phone
(309) 662-7722

Authorized Official

Name
DR. RICHARD A. STEPHEY, DDS
Title
CEO
Phone
(309) 662-7722

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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