| Children's Center for Dentistry | |
|
314 Susan Dr Normal IL 61761-6206 | |
| (309) 827-5437 | |
| (309) 265-0288 |
| Full Name | Children's Center for Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 314 Susan Dr, Normal, Illinois |
| Authorized Official Name and Position | Mackenzie Starkey (OFFICE MANAGER) |
| Authorized Official Contact | 3098275437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Center for Dentistry 314 Susan Dr Normal IL 61761-6206 Ph: (309) 827-5437 | Children's Center for Dentistry 314 Susan Dr Normal IL 61761-6206 Ph: (309) 827-5437 |
| NPI Number | 1932709433 |
|---|---|
| Provider Enumeration Date | 10/26/2020 |
| Last Update Date | 04/19/2021 |
| Certification Date | 04/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932709433 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (NU) | Primary |
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