| Coal City Dental Center | |
|
645 E Division St Coal City IL 60416-1679 | |
| (815) 634-4999 | |
| (815) 634-0014 |
| Full Name | Coal City Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 645 E Division St, Coal City, Illinois |
| Authorized Official Name and Position | Robin Lynn Trevison (DENTIST) |
| Authorized Official Contact | 8156344999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coal City Dental Center 645 E Division St Coal City IL 60416-1679 Ph: (815) 634-4999 | Coal City Dental Center 645 E Division St Coal City IL 60416-1679 Ph: (815) 634-4999 |
| NPI Number | 1356604672 |
|---|---|
| Provider Enumeration Date | 06/21/2012 |
| Last Update Date | 06/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356604672 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019020745 (Illinois) | Primary |
Pullara Family Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 595 N Broadway St, Coal City, IL 60416 Phone: 815-634-8009 Fax: 815-634-2008 | |
Broadway Family Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 595 N Broadway St, Coal City, IL 60416 Phone: 815-634-8009 Fax: 815-634-2008 |