Organization
DENTAL HEALTH PROFESSIONALS OF ILLINOIS, P.C.
Active
Other names
Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA BUIE (SENIOR CREDENTIALING COORDINATOR)
(217) 670-6979
Entity
Organization
Contact information
Practice address
1431 MCHENRY RD STE 108, BUFFALO GROVE, IL 60089-1378
(847) 808-0505
Mailing address
1431 MCHENRY RD STE 108, BUFFALO GROVE, IL 60089-1378
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/02/2019
Last updated
07/31/2023
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