Individual
DR. COLLIN PETOSKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7620 N UNIVERSITY ST STE 109, PEORIA, IL 61614-8300
(309) 693-0043
Mailing address
602 W MOUNT HAWLEY TER, PEORIA, IL 61615-2141
(309) 693-0043
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.030409
IL
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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