Organization
ROCK RIVER ORAL SURGERY & DENTAL IMPLANT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEA MCCUE DDS (ORAL SURGEON/OWNER)
(815) 399-1234
Entity
Organization
Contact information
Practice address
973 FEATHERSTONE RD, SUITE 102, ROCKFORD, IL 61107-5912
(815) 399-1234
(815) 399-2423
Mailing address
973 FEATHERSTONE RD, SUITE 102, ROCKFORD, IL 61107-5912
(815) 399-1234
(815) 399-2423
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
019030148
WI
Other
Enumeration date
06/23/2015
Last updated
06/23/2015
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