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Organization
TIMOTHY E. SKIDMORE, D.D.S., P.C.
Active
Organization
TIMOTHY E. SKIDMORE, D.D.S., P.C.
Active
Other names
Mill Creek Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY EMERSON SKIDMORE D.D.S. (PRESIDENT)
(630) 208-0051
Entity
Organization
Contact information
Practice address
39W250 HERRINGTON BLVD, SUITE F1, GENEVA, IL 60134-6192
(630) 208-0051
Mailing address
39W250 HERRINGTON BLVD, SUITE F1, GENEVA, IL 60134-6192
(630) 208-0051
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019025894
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189948
—
IL
Enumeration date
07/24/2008
Last updated
07/24/2008
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