Dental Sealants & More

NPI #1770755852 in Peoria, Illinois

Provider Information

NPI Number: 1770755852
Entity Type: Organization
Organization Name: Dental Sealants & More
Subpart: Yes (part of a larger organization)
Parent Organization: DENTAL SEALANTS & MORE
Primary Specialty: Dentist
Enumeration Date: Mar 28, 2008
Last Updated: Feb 8, 2017

Practice Location

Address: 2126 N. UNIVERSITY ST.
City: Peoria
State: Illinois
ZIP Code: 61604
Phone: (309) 339-4433

Authorized Official

Name: RENEE KATHERINE DIETZ, DMD
Title: PRESIDENT
Phone: (309) 339-4433

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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