Organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Other names
Springfield Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Authorized official
JESSICA BRITT (CREDENTIALING COORDINATOR)
(217) 540-8426
Entity
Organization
Contact information
Practice address
3820 WABASH AVE, SPRINGFIELD, IL 62711
(217) 698-1717
Mailing address
3820 WABASH AVE, SPRINGFIELD, IL 62711-6467
(217) 698-1717
(217) 698-7134
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/03/2007
Last updated
07/12/2018
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