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Organization

APPLEWHITE DENTAL ILLINOIS, P.C.

Active
Parent organization
APPLEWHITE DENTAL ILLINOIS, P.C.
Other names
McLean County Dental-Bloomington
Organization subpart
Yes

Provider details

NPI number
Legal business name
APPLEWHITE DENTAL ILLINOIS, P.C.
Authorized official
SHARON L LOSO (CREDENTIALING SPECIALIST)
(563) 582-1448
Entity
Organization

Contact information

Practice address
2103 E WASHINGTON ST STE 1C, BLOOMINGTON, IL 61701-4365
(309) 662-8448
(309) 662-7617
Mailing address
40 MAIN ST STE 100, DUBUQUE, IA 52001-7654
(563) 582-1448
(563) 556-1326

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
08/13/2018
Last updated
07/29/2019
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