Organization
SHADY OAK DENTAL - BYRON DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT BARES DDS (PRESIDENT)
(815) 275-2680
Entity
Organization
Contact information
Practice address
503 W BLACKHAWK DR, BYRON, IL 61010-9647
(309) 369-3284
Mailing address
1342 S HARLEM AVE, FREEPORT, IL 61032-6231
(309) 369-3284
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/06/2025
Last updated
11/06/2025
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