| Buffalo Prairie Dental Care Of Macomb, Inc | |
|
200 S Mcarthur St Macomb IL 61455-2143 | |
| (309) 833-2882 | |
| (309) 833-3210 |
| Full Name | Buffalo Prairie Dental Care Of Macomb, Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 200 S Mcarthur St, Macomb, Illinois |
| Authorized Official Name and Position | Michael O Connolly (PRESIDENT) |
| Authorized Official Contact | 3098332882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Buffalo Prairie Dental Care Of Macomb, Inc 200 S Mcarthur St Macomb IL 61455-2143 Ph: (309) 833-2882 | Buffalo Prairie Dental Care Of Macomb, Inc 200 S Mcarthur St Macomb IL 61455-2143 Ph: (309) 833-2882 |
| NPI Number | 1053321109 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 07/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053321109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019025916 (Illinois) | Primary |
Lifetime Dental Care Of Illinois, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 W Jackson, Macomb, IL 61455 Phone: 309-836-6688 Fax: 309-836-6119 |