Organization
ILLINI SMILES DENTAL CARE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YUDONG XU (PRESIDENT)
(217) 892-8868
Entity
Organization
Contact information
Practice address
225 N MARKET ST, PAXTON, IL 60957-1189
(217) 379-4614
Mailing address
730 ENTERPRISE, RANTOUL, IL 61866-3689
(217) 892-8868
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/20/2017
Last updated
06/20/2017
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