Organization
SHADY OAK DENTAL LLC - ROCHELLE FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT BARES (DOCTOR)
(815) 275-2680
Entity
Organization
Contact information
Practice address
409 LINCOLN HWY, ROCHELLE, IL 61068-1642
(815) 561-6058
Mailing address
409 LINCOLN HWY, ROCHELLE, IL 61068-1642
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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