# TAZEWELL COUNTY HEALTH DEPARTMENT -DENTAL HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649308230
- **Authorized official:** DR. JERRY LEE MARSHALL DMD (DIRECTOR OF DENTAL SERVICES)
- **Authorized official phone:** (309) 382-2229

## Contact information

- **Practice address:** 135 RADIO CITY DRIVE, SUITE A & B, NORTH PEKIN, IL 61554
- **Practice address phone:** (309) 382-2229
- **Practice address fax:** (309) 382-1155
- **Mailing address:** 135 RADIO CITY DRIVE, SUITE A & B, NORTH PEKIN, IL 61554
- **Mailing address phone:** (309) 382-2229
- **Mailing address fax:** (309) 382-1155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | E9993-0978-05 | IL | Yes |

## Other

- **Enumeration date:** 03/02/2007
- **Last updated:** 06/20/2008