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Organization
SHADY OAK DENTAL LLC - BURLINGTON DENTAL
Active
Organization
SHADY OAK DENTAL LLC - BURLINGTON DENTAL
Active
Parent organization
SHADY OAK DENTAL LLC
Other names
Burlington Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHADY OAK DENTAL LLC
Authorized official
DR. SCOTT C BARES DDS (PRESIDENT)
(815) 938-2575
Entity
Organization
Contact information
Practice address
255 S MAIN ST, BURLINGTON, IL 60109-1116
(847) 683-9812
Mailing address
255 S MAIN ST, BURLINGTON, IL 60109-1116
(847) 683-9812
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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