Organization
CHAUNCEY CROSS DDS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN CHAUNCEY CROSS D.D.S. (PRESIDENT OF CORPORATION)
(217) 787-0212
Entity
Organization
Contact information
Practice address
1001 CLOCK TOWER DR, SPRINGFIELD, IL 62704-1383
(217) 787-0212
(217) 793-1490
Mailing address
1001 CLOCK TOWER DR, SPRINGFIELD, IL 62704-1383
(217) 787-0212
(217) 793-1490
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019020191
IL
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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