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Organization
PREMIER DENTAL CLINC, LLC
Active
Organization
PREMIER DENTAL CLINC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHIL KURAL (DIRECTOR DOCTOR CREDENTIALING)
(312) 274-4526
Entity
Organization
Contact information
Practice address
7345 W 25TH ST, NORTH RIVERSIDE, IL 60546-1409
(708) 447-0900
Mailing address
7345 W 25TH ST, NORTH RIVERSIDE, IL 60546-1409
(708) 447-0900
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019024846
IL
Other
Enumeration date
03/18/2008
Last updated
03/20/2020
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