Individual
MR. HEATHER L DENTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
6708 N KNOXVILLE AVE, PEORIA, IL 61614-2862
(309) 692-6838
(309) 691-6858
Mailing address
6708 N KNOXVILLE AVE, PEORIA, IL 61614-2862
(309) 692-6838
(309) 691-6858
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
209026831
IL
Other
Enumeration date
02/27/2023
Last updated
02/27/2023
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