Organization
ILLINI SMILES DENTAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YUDONG XU DMD (PRESIDENT)
(217) 356-3335
Entity
Organization
Contact information
Practice address
201 W SPRINGFIELD AVE STE 506, CHAMPAIGN, IL 61820-6383
(217) 356-3335
Mailing address
701 DEVONSHIRE DR, D-1, CHAMPAIGN, IL 61820-7337
(217) 356-3335
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019026810
IL
Other
Enumeration date
08/11/2014
Last updated
07/27/2020
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