Individual
BEAU HENDREN-SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
405 S PROSPECT RD, BLOOMINGTON, IL 61704-4900
(309) 830-4382
Mailing address
405 S PROSPECT RD, BLOOMINGTON, IL 61704-4900
(309) 830-4382
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
319.025320
IL
Other
Enumeration date
06/30/2026
Last updated
06/30/2026
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