Heritage Grove Family Dental P.c.

NPI 1013336445 - Dentist - 1223G0001X

NPI Details
NPI 1013336445
Enumeration Date 04/14/2014
Last Updated 04/14/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name PETE A PETE
Position DENTIST
Phone (815) 254-1375
Fax
Practice Location
12426 S VAN DYKE RD
UNIT B
PLAINFIELD IL, 60585-2700, US
Phone (815) 254-1375
Fax
Business Location
12426 S VAN DYKE RD
UNIT B
PLAINFIELD IL, 60585-2700, US
Phone
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Illinois
License Number 019025501
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According to our database, Heritage Grove Family Dental P.c. NPI is 1013336445, taxonomy code is 1223G0001X and license number is 019025501, license state is located at Illinois. Heritage Grove Family Dental P.c. physically located at 12426 S Van Dyke Rd, Plainfield IL, 60585-2700. NPI Number 1033115704 has the healthcare provider type.

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1013336445 NPI number is provided on an as is basis without warranty of any kind. 1013336445 is maintained by the National Plan & Provider Enumeration System. The contents of Heritage Grove Family Dental P.c. are for informational purposes only.