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Organization
RICKARD ROAD DENTAL GROUP
Active
Organization
RICKARD ROAD DENTAL GROUP
Active
Other names
Cummins Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ETHAN DUEWER (DENTIST)
(217) 691-7778
Entity
Organization
Contact information
Practice address
1140 RICKARD RD STE 1, SPRINGFIELD, IL 62704-6385
(217) 787-3096
Mailing address
1140 RICKARD RD STE 1, SPRINGFIELD, IL 62704-6385
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/18/2022
Last updated
01/18/2022
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