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Organization
PHILCO DENTAL GROUP LLC - CHAMPAIGN
Active
Organization
PHILCO DENTAL GROUP LLC - CHAMPAIGN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AARON PHILLIPS (OWNER)
(217) 204-9025
Entity
Organization
Contact information
Practice address
1902 N PROSPECT AVE STE 1, CHAMPAIGN, IL 61822-1411
(217) 204-9025
Mailing address
PO BOX 70887, CLEVELAND, OH 44190-0887
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/03/2017
Last updated
06/13/2023
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