Organization
LIFETIME DENTAL CARE OF ILLINOIS, PC
Active
Other names
Macomb Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
AMY KROEGER (INS COOD)
(217) 540-5100
Entity
Organization
Contact information
Practice address
1200 W JACKSON, MACOMB, IL 61455
(309) 836-6688
(309) 836-6119
Mailing address
1200 W JACKSON ST STE 5, MACOMB, IL 61455-1175
(309) 836-6688
(309) 836-6119
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/03/2007
Last updated
10/13/2025
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