Organization
RICKARD ROAD DENTAL GROUP
Active
Other names
Cummins Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ETHAN DUEWER (DENTIST)
(217) 691-7778
Entity
Organization
Contact information
Practice address
1140 RICKARD RD STE 1, SPRINGFIELD, IL 62704-6385
(217) 787-3096
Mailing address
1140 RICKARD RD STE 1, SPRINGFIELD, IL 62704-6385
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/18/2022
Last updated
01/18/2022
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