Organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Other names
Smile For Life Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Authorized official
LINDSAY BEARDEN (INS COOD)
(217) 540-5100
Entity
Organization
Contact information
Practice address
4971 S. STATE RTE 159, MARYVILLE, IL 62062
(618) 288-6699
(618) 288-8977
Mailing address
4971 S. STATE RTE 159, MARYVILLE, IL 62062
(618) 288-6699
(618) 288-8977
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/03/2007
Last updated
01/08/2014
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