Familia Dental Peoria 2 Llc

NPI 1740500974 - Dentist - 1223G0001X

NPI Details
NPI 1740500974
Enumeration Date 06/10/2010
Last Updated 06/10/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name KOUSHAN H. KOUSHAN
Position PRESIDENT/OWNER
Phone (888) 988-4066
Fax
Practice Location
1403 W. GLEN
PEORIA IL, 61614, US
Phone (888) 988-4066
Fax
Business Location
2000 E ALGONQUIEN RD SUITE 109
SCHAUMBURG IL, 60173-4189, US
Phone (888) 988-4066
Fax (847) 496-7603
Toxanomy
Taxonomy Code 1223G0001X
License State
License Number
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According to our database, Familia Dental Peoria 2 Llc NPI is 1740500974, taxonomy code is 1223G0001X Familia Dental Peoria 2 Llc physically located at 1403 W. Glen, Peoria IL, 61614. NPI Number 1033115704 has the healthcare provider type.

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1740500974 NPI number is provided on an as is basis without warranty of any kind. 1740500974 is maintained by the National Plan & Provider Enumeration System. The contents of Familia Dental Peoria 2 Llc are for informational purposes only.