Avid Dental Pc

NPI 1083802524 - Dentist - 1223G0001X

NPI Details
NPI 1083802524
Enumeration Date 10/10/2007
Last Updated 10/10/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name DAVID JOSEPH DAVID
Position PRESIDENT/OWNER
Phone (815) 483-2040
Fax (815) 483-2071
Practice Location
115 REPUBLIC AVE
JOLIET IL, 60435-6515, US
Phone (815) 483-2040
Fax (815) 483-2071
Business Location
115 REPUBLIC AVE
JOLIET IL, 60435-6515, US
Phone (815) 483-2040
Fax (815) 483-2071
Toxanomy
Taxonomy Code 1223G0001X
License State Illinois
License Number 19016647
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According to our database, Avid Dental Pc NPI is 1083802524, taxonomy code is 1223G0001X and license number is 19016647, license state is located at Illinois. Avid Dental Pc physically located at 115 Republic Ave, Joliet IL, 60435-6515. NPI Number 1033115704 has the healthcare provider type.

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1083802524 NPI number is provided on an as is basis without warranty of any kind. 1083802524 is maintained by the National Plan & Provider Enumeration System. The contents of Avid Dental Pc are for informational purposes only.