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Organization
RENKEN DENTISTRY PC
Active
Organization
RENKEN DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA M RENKEN D.D.S. (OWNER)
(217) 483-7177
Entity
Organization
Contact information
Practice address
2801 MANSION RD, SPRINGFIELD, IL 62711-6724
(217) 483-7177
(217) 483-7190
Mailing address
2801 MANSION RD, SPRINGFIELD, IL 62711-6724
(217) 483-7177
(217) 483-7190
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019025823
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9183211
—
IL
Enumeration date
01/02/2008
Last updated
08/28/2019
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