Tru Dental Illinois, P.c.

NPI #1912599176 in Flossmoor, Illinois

Provider Information

NPI Number: 1912599176
Entity Type: Organization
Organization Name: Tru Dental Illinois, P.c.
Subpart: Yes (part of a larger organization)
Parent Organization: TRU DENTAL ILLINOIS, P.C.
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 9, 2021
Last Updated: Feb 9, 2021

Practice Location

Address: 19509 GOVERNORS HWY
City: Flossmoor
State: Illinois
ZIP Code: 60422-2097
Phone: (708) 647-7509

Authorized Official

Name: CELIA HAYES
Title: CREDENTIALING COORDINATOR
Phone: (217) 540-2100

Specialties & Taxonomy Codes

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

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