Buffalo Prairie Dental Care of Pittsfield, INC

NPI #1760667307 in Pittsfield, Illinois

Provider Information

NPI Number: 1760667307
Entity Type: Organization
Organization Name: Buffalo Prairie Dental Care of Pittsfield, INC
Primary Specialty: Dentist
Enumeration Date: Jan 2, 2008
Last Updated: Jan 2, 2008

Practice Location

Address: 850 N JACKSON ST
City: Pittsfield
State: Illinois
ZIP Code: 62363-1206
Phone: (217) 285-4084

Authorized Official

Name: DR. ROY GLENN NORTHCUTT, DMD
Title: OWNER
Phone: (217) 285-4084

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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