Organization
KIDS FIRST DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA DONLAN DDS (OWNER)
(309) 692-0175
Entity
Organization
Contact information
Practice address
7314 N WILLOW LAKE CT STE D, PEORIA, IL 61614-8289
(309) 692-0175
(309) 692-3139
Mailing address
7314 N WILLOW LAKE CT STE D, PEORIA, IL 61614-8289
(309) 692-0175
(309) 692-3139
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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