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Organization

DENTAL PROFESSIONALS OF ILLINOIS, P.C.

Active
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Other names
Premier Dental Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Authorized official
CASSANDRA PETERSEN (CREDENTIALING TEAM LEAD)
(217) 540-8972
Entity
Organization

Contact information

Practice address
309 W OGDEN AVE, NAPERVILLE, IL 60563-3000
(630) 355-3339
Mailing address
309 W OGDEN AVE, NAPERVILLE, IL 60563-3000
(630) 355-3339

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
02/16/2018
Last updated
02/16/2018
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