Individual
DR. ERIC THOMAS SUDHOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
838 W GLEN AVE, PEORIA, IL 61614-4835
(309) 691-1990
Mailing address
838 W GLEN AVE, PEORIA, IL 61614-4835
(309) 691-1990
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019028324
IL
Other
Enumeration date
02/18/2011
Last updated
02/18/2011
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