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Organization
DR MOSQUERA PROSTHODONTICS PLLC
Active
Organization
DR MOSQUERA PROSTHODONTICS PLLC
Active
Other names
MAKEOVER DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE ENRIQUE MOSQUERA CASTRILLON DDS (DENTIST)
(561) 635-8018
Entity
Organization
Contact information
Practice address
687 E LINTON AVE, SPRINGFIELD, IL 62703-5902
(718) 909-2550
Mailing address
3500 SANDPIPER DR, SPRINGFIELD, IL 62711-6722
(561) 635-8018
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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