Organization
COTTAGE DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS R KRUG DDS (MEMBER)
(309) 828-1463
Entity
Organization
Contact information
Practice address
2206 COTTAGE AVE, BLOOMINGTON, IL 61701-1447
(309) 828-1463
Mailing address
2206 COTTAGE AVE, BLOOMINGTON, IL 61701-1447
(309) 828-1463
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-018709
IL
Other
Enumeration date
02/03/2014
Last updated
02/03/2014
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