Organization
KRALLYODER PC
Active
Other names
Metamora Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE ANDREW KRALL DDS (PRESIDENT)
(309) 367-2378
Entity
Organization
Contact information
Practice address
212 N DAVENPORT ST, METAMORA, IL 61548-9395
(309) 369-2378
Mailing address
212 N DAVENPORT ST, PO BOX 920, METAMORA, IL 61548-9395
(309) 369-2378
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019018768
IL
1223G0001X
General Practice Dentistry
Primary
019025832
IL
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
07/01/2008
Last updated
05/04/2022
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