Affordable Dental Of Illinois

NPI 1063552453 - Clinic/Center - 261QD0000X

NPI Details
NPI 1063552453
Enumeration Date 02/07/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name RONALD D RONALD
Position OWNER
Phone (618) 286-4400
Fax
Practice Location
195 S MAIN ST
DUPO IL, 62239-1347, US
Phone (618) 286-4400
Fax
Business Location
195 S MAIN ST
DUPO IL, 62239-1347, US
Phone
Fax
Toxanomy
Taxonomy Code 261QD0000X
License State
License Number
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According to our database, Affordable Dental Of Illinois NPI is 1063552453, taxonomy code is 261QD0000X Affordable Dental Of Illinois physically located at 195 S Main St, Dupo IL, 62239-1347. NPI Number 1033115704 has the healthcare provider type.

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1063552453 NPI number is provided on an as is basis without warranty of any kind. 1063552453 is maintained by the National Plan & Provider Enumeration System. The contents of Affordable Dental Of Illinois are for informational purposes only.