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Organization
PEORIA DENTAL CARE
Active
Organization
PEORIA DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WYNN DDS (DENTIST)
(309) 688-0121
Entity
Organization
Contact information
Practice address
4517 N ROCKWOOD DR, PEORIA, IL 61615-3841
(309) 688-0121
Mailing address
4517 N ROCKWOOD DR, PEORIA, IL 61615-3841
(309) 688-0121
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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