Organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C
Active
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C
Other names
Hickory Creek Family Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, P.C
Authorized official
LINDSAY BEARDEN (CREDENTIALING COORDINATOR)
(217) 540-5699
Entity
Organization
Contact information
Practice address
561 E LINCOLN HWY, NEW LENOX, IL 60451
(815) 981-9046
Mailing address
561 E LINCOLN HWY, NEW LENOX, IL 60451
(815) 981-9046
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/25/2015
Last updated
02/27/2015
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