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Organization

KEVIN K SCHULTZ, DDS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEVIN KELSO SCHULTZ D.D.S. (PRESIDENT)
(309) 663-1721
Entity
Organization

Contact information

Practice address
10 HEARTLAND DR, SUITE C, BLOOMINGTON, IL 61704-7741
(309) 663-1721
Mailing address
10 HEARTLAND DR, SUITE C, BLOOMINGTON, IL 61704-7741
(309) 663-1721

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019.018656
IL

Other

Enumeration date
03/02/2015
Last updated
03/02/2015
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