Lifetime Dental Care of Illinois, PC
NPI #1720200074 in Springfield, Illinois
Provider Information
- NPI Number
- 1720200074
- Entity Type
- Organization
- Organization Name
- Lifetime Dental Care of Illinois, PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 3, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 3124 MONTVALE DRIVE
- City
- Springfield
- State
- Illinois
- ZIP Code
- 62704
- Phone
- (217) 546-8777
Authorized Official
- Name
- AMY KROEGER
- Title
- INS COOD
- Phone
- (217) 540-5100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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