Organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Other names
Complete Dental of Frankfort
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
590 BANKVIEW DR STE A, FRANKFORT, IL 60423-1858
(815) 469-3373
Mailing address
590 BANKVIEW DR STE A, FRANKFORT, IL 60423-1858
(815) 469-3373
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/28/2018
Last updated
03/28/2018
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