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Organization

MAGNA DENTAL, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CANDACE CHRISTINE CUMMINS (TREASURER/BOOKKEEPER)
(217) 381-3681
Entity
Organization

Contact information

Practice address
1825 S 6TH ST, SPRINGFIELD, IL 62703-3122
(217) 525-6980
(217) 525-6984
Mailing address
1825 S 6TH ST, SPRINGFIELD, IL 62703-3122
(217) 525-6980
(217) 525-6984

Taxonomy

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

Other

Enumeration date
08/20/2014
Last updated
02/05/2015
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