Organization
FHN MEMORIAL ENTERPRISES
Active
Other names
Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL PERRY M.D. (C.E.O.)
(815) 235-2600
Entity
Organization
Contact information
Practice address
1768 S ROSENSTIEL DR, FREEPORT, IL 61032
(815) 235-2600
(815) 235-9846
Mailing address
1768 S ROSENSTIEL DR, FREEPORT, IL 61032
(815) 235-2600
(815) 235-9846
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004800
—
IL
05
—
1005536
—
IL
05
—
9177538
—
IL
05
—
9178466
—
IL
Enumeration date
06/08/2006
Last updated
08/22/2020
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