Organization
MARCIN DENTAL CENTERS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSEANNE BRUNENKANT (OFFICE MANAGER)
(309) 274-6237
Entity
Organization
Contact information
Practice address
7620 N UNIVERSITY, PEORIA, IL 61614
(309) 693-0043
(309) 693-0422
Mailing address
7620 N UNIVERSITY, PEORIA, IL 61614
(309) 693-0043
(309) 693-0422
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019013646
IL
Other
Enumeration date
12/12/2006
Last updated
04/26/2012
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