Organization
CHILDREN'S CENTER FOR DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MACKENZIE STARKEY (OFFICE MANAGER)
(309) 827-5437
Entity
Organization
Contact information
Practice address
314 SUSAN DR, NORMAL, IL 61761-6206
(309) 827-5437
(309) 265-0288
Mailing address
314 SUSAN DR, NORMAL, IL 61761-6206
(309) 827-5437
(309) 265-0288
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
10/26/2020
Last updated
04/19/2021
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