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Organization

DENTAL PROFESSIONALS OF ILLINOIS, P.C.

Active
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Other names
Boulevard Place Dental Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Authorized official
BELINDA HUERTA (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization

Contact information

Practice address
16302 S BOULEVARD PL UNIT 102, PLAINFIELD, IL 60586-4403
(815) 676-3337
(815) 676-3734
Mailing address
16302 S BOULEVARD PL UNIT 102, PLAINFIELD, IL 60586-4403
(815) 676-3337
(815) 676-3734

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
08/29/2023
Last updated
08/29/2023
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