# CHILDREN'S CENTER FOR DENTISTRY

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

## Provider details

- **NPI number:** 1932709433
- **Authorized official:** MRS. MACKENZIE STARKEY (OFFICE MANAGER)
- **Authorized official phone:** (309) 827-5437

## Contact information

- **Practice address:** 314 SUSAN DR, NORMAL, IL 61761-6206
- **Practice address phone:** (309) 827-5437
- **Practice address fax:** (309) 265-0288
- **Mailing address:** 314 SUSAN DR, NORMAL, IL 61761-6206
- **Mailing address phone:** (309) 827-5437
- **Mailing address fax:** (309) 265-0288

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/26/2020
- **Last updated:** 04/19/2021