| Edp Of Illinois P.c | |
|
195 S Main St Dupo IL 62239-1347 | |
| (312) 800-1270 | |
| Not Available |
| Full Name | Edp Of Illinois P.c |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 195 S Main St, Dupo, Illinois |
| Authorized Official Name and Position | Melissa Garibay (CREDENTIALING MANAGER) |
| Authorized Official Contact | 3127368963 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edp Of Illinois P.c 141 W Jackson Blvd Ste 210 Chicago IL 60604-3048 Ph: (312) 800-1270 | Edp Of Illinois P.c 195 S Main St Dupo IL 62239-1347 Ph: (312) 800-1270 |
| NPI Number | 1154712784 |
|---|---|
| Provider Enumeration Date | 02/18/2015 |
| Last Update Date | 09/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154712784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 021.001656 (Illinois) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Affordable Dental Of Illinois Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 195 S Main St, Dupo, IL 62239 Phone: 618-286-4400 | |
Affordable Dentistry Of Il Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 195 S Main St, Dupo, IL 62239 Phone: 618-286-4400 |