Organization
WILLIAM E. CUSACK, D.D.S., LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY SUE CUSACK (PRESIDENT)
(309) 360-8592
Entity
Organization
Contact information
Practice address
5013 N UNIVERSITY ST STE 2, PEORIA, IL 61614-4796
(309) 693-2220
(309) 693-2272
Mailing address
5013 N UNIVERSITY ST STE 2, PEORIA, IL 61614-4796
(309) 693-2220
(309) 693-2272
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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