Familia Dental Springfield Llc

NPI 1780974568 - Dentist - 1223G0001X

NPI Details
NPI 1780974568
Enumeration Date 04/13/2011
Last Updated 04/13/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name KOUSHAN KOUSHAN
Position PRESIDENT
Phone (888) 988-4066
Fax (847) 496-7603
Practice Location
802 N 9TH ST
SPRINGFIELD IL, 62702-6309, US
Phone (888) 988-4066
Fax (847) 496-7603
Business Location
2000 E ALGONQUIN RD
SUITE 109
SCHAUMBURG IL, 60173-4189, US
Phone (888) 988-4066
Fax (847) 496-7603
Toxanomy
Taxonomy Code 1223G0001X
License State Illinois
License Number 019026920
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According to our database, Familia Dental Springfield Llc NPI is 1780974568, taxonomy code is 1223G0001X and license number is 019026920, license state is located at Illinois. Familia Dental Springfield Llc physically located at 802 N 9th St, Springfield IL, 62702-6309. NPI Number 1033115704 has the healthcare provider type.

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1780974568 NPI number is provided on an as is basis without warranty of any kind. 1780974568 is maintained by the National Plan & Provider Enumeration System. The contents of Familia Dental Springfield Llc are for informational purposes only.