Organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Other names
Mokena Crossings Family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Authorized official
KIM WILSON (CRED SUPERIVOSR)
(217) 540-5170
Entity
Organization
Contact information
Practice address
9990 W 190TH ST, SUITE D, MOKENA, IL 60448-8188
(708) 479-9797
(708) 478-4571
Mailing address
9990 W 190TH ST, SUITE D, MOKENA, IL 60448-8188
(708) 479-9797
(708) 478-4571
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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