Organization
ACCESS DENTAL OF NORMAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA CARRILLO (REGIONAL DIRECTOR)
(512) 351-2612
Entity
Organization
Contact information
Practice address
305 S LINDEN ST STE 101, NORMAL, IL 61761-4906
(309) 296-0227
Mailing address
305 S LINDEN ST STE 101, NORMAL, IL 61761-4906
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/09/2021
Last updated
12/09/2021
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