Dr. Paul & Dr. Anderson, Dental Pc

NPI 1154728228 - Dentist - 1223G0001X

NPI Details
NPI 1154728228
Enumeration Date 12/04/2014
Last Updated 12/04/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name ROGER ROGER
Position DENTIST
Phone (309) 682-0770
Fax
Practice Location
521 W LAKE AVE
PEORIA IL, 61614-6020, US
Phone (309) 682-0770
Fax
Business Location
521 W. LAKE AVE
PEORIA IL, 61614, US
Phone (309) 682-0770
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Illinois
License Number 1916423
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According to our database, Dr. Paul & Dr. Anderson, Dental Pc NPI is 1154728228, taxonomy code is 1223G0001X and license number is 1916423, license state is located at Illinois. Dr. Paul & Dr. Anderson, Dental Pc physically located at 521 W Lake Ave, Peoria IL, 61614-6020. NPI Number 1033115704 has the healthcare provider type.

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1154728228 NPI number is provided on an as is basis without warranty of any kind. 1154728228 is maintained by the National Plan & Provider Enumeration System. The contents of Dr. Paul & Dr. Anderson, Dental Pc are for informational purposes only.