Individual
MIKAYLIN WOODSIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4517 N ROCKWOOD DR, PEORIA, IL 61615-3841
(309) 688-0121
Mailing address
4517 N ROCKWOOD DR, PEORIA, IL 61615-3841
(309) 688-0121
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.036126
IL
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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