Organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C
Active
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Other names
Innovative Pediatric Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization
Contact information
Practice address
55 S MAIN ST STE 261, NAPERVILLE, IL 60540-5372
(630) 848-7336
Mailing address
55 S MAIN ST STE 261, NAPERVILLE, IL 60540-5372
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/14/2021
Last updated
04/14/2021
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