Perryville Dentist PC

NPI #1730547936 in Rockford, Illinois

Provider Information

NPI Number: 1730547936
Entity Type: Organization
Organization Name: Perryville Dentist PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 2, 2016
Last Updated: Feb 2, 2016

Practice Location

Address: 845 S PERRYVILLE RD
Address 2: UNIT 119
City: Rockford
State: Illinois
ZIP Code: 61108
Phone: (847) 354-0127

Authorized Official

Name: JABAL R PATEL, DMD
Title: OWNER
Phone: (847) 354-0127

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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