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Organization

MCLEAN COUNTY DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EMIL M. VERBAN JR. DDS (OWNER)
(309) 662-8448
Entity
Organization

Contact information

Practice address
2103 E WASHINGTON ST, SUITE 1C, BLOOMINGTON, IL 61701-4310
(309) 662-8448
(309) 662-7617
Mailing address
2103 E WASHINGTON ST, SUITE 1C, BLOOMINGTON, IL 61701-4310
(309) 662-8448
(309) 662-7617

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019015656
IL

Other

Enumeration date
05/04/2012
Last updated
05/04/2012
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