Dental Professionals of Illinois, P.c.
NPI #1629471016 in Beardstown, Illinois
Provider Information
- NPI Number
- 1629471016
- 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
- Sep 30, 2014
- Last Updated
- Sep 30, 2014
Practice Location
- Address
- 507 WASHINGTON ST
- City
- Beardstown
- State
- Illinois
- ZIP Code
- 62618-1558
- Phone
- (217) 232-2701
Authorized Official
- Name
- KIM WILSON
- Title
- CRED SUPERVISOR
- Phone
- (217) 540-5170
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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