Organization
ILLINI SMILES DENTAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YUDONG XU DMD (PRESIDENT)
(217) 607-1292
Entity
Organization
Contact information
Practice address
125 W MAIN ST, URBANA, IL 61801-2714
(217) 607-1292
Mailing address
125 W MAIN ST, URBANA, IL 61801-2714
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019026810
IL
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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