Lifetime Dental Care of Illinois, PC
NPI #1700099066 in Springfield, Illinois
Provider Information
- NPI Number
- 1700099066
- Entity Type
- Organization
- Organization Name
- Lifetime Dental Care of Illinois, PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 7, 2007
- Last Updated
- Feb 1, 2022
Practice Location
- Address
- 2701 S KOKE MILL RD
- City
- Springfield
- State
- Illinois
- ZIP Code
- 62711-8194
- Phone
- (217) 793-8899
Authorized Official
- Name
- CELIA HAYES
- Title
- CREDENTIALING COORDINATOR
- Phone
- (217) 540-2100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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