Organization
KNOX FAMILY DENTAL LLC
Active
Other names
Knox Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLLIN PETOSKEY D.D.S. (DENTIST/OWNER)
(309) 738-6224
Entity
Organization
Contact information
Practice address
1172 MONROE ST STE 7, GALESBURG, IL 61401-2554
(309) 343-9229
Mailing address
1172 MONROE ST STE 7, GALESBURG, IL 61401-2554
(309) 343-9229
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019030409
IL
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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