Organization
TIMOTHY E. SKIDMORE, D.D.S., P.C.
Active
Other names
Mill Creek Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY EMERSON SKIDMORE D.D.S. (PRESIDENT)
(630) 208-0051
Entity
Organization
Contact information
Practice address
39W250 HERRINGTON BLVD, SUITE F1, GENEVA, IL 60134-6192
(630) 208-0051
Mailing address
39W250 HERRINGTON BLVD, SUITE F1, GENEVA, IL 60134-6192
(630) 208-0051
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019025894
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189948
—
IL
Enumeration date
07/24/2008
Last updated
07/24/2008
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