Organization
BUFFALO PRAIRIE DENTAL CARE OF PITTSFIELD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY GLENN NORTHCUTT DMD (OWNER)
(217) 285-4084
Entity
Organization
Contact information
Practice address
850 N JACKSON ST, PITTSFIELD, IL 62363-1206
(217) 285-4084
Mailing address
850 N JACKSON ST, PITTSFIELD, IL 62363-1206
(217) 285-4084
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0190242471
IL
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
01/02/2008
Last updated
01/02/2008
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