Organization
DR. MARC C THEVENIN JR. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC THEVENIN (OWNER)
(309) 674-2000
Entity
Organization
Contact information
Practice address
5116 N BIG HOLLOW RD STE 101, PEORIA, IL 61615-3514
(309) 674-2000
Mailing address
PO BOX 70887, CLEVELAND, OH 44190-0887
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/01/2017
Last updated
06/20/2023
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