| Custom Dental Care, P.c. | |
|
3740 E Lake Ctr Ste B Quincy IL 62305-5805 | |
| (217) 214-4545 | |
| (217) 214-4546 |
| Full Name | Custom Dental Care, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 3740 E Lake Ctr Ste B, Quincy, Illinois |
| Authorized Official Name and Position | Dennis Ryan Wagner (OWNER/PRESIDENT) |
| Authorized Official Contact | 2174301429 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Dental Care, P.c. 3740 E Lake Ctr Ste B Quincy IL 62305-5805 Ph: (217) 214-4545 | Custom Dental Care, P.c. 3740 E Lake Ctr Ste B Quincy IL 62305-5805 Ph: (217) 214-4545 |
| NPI Number | 1932452893 |
|---|---|
| Provider Enumeration Date | 10/17/2012 |
| Last Update Date | 10/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932452893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019027406 (Illinois) | Primary |
Dale D. Shahan Dds Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 636 Hampshire Suite 102, Quincy, IL 62301 Phone: 217-228-0101 Fax: 217-222-7011 | |
Paul E. Obrock, Dmd, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 334 S 8th St, Quincy, IL 62301 Phone: 217-222-4180 | |
Quincy Dental Specialists Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 Hampshire, Quincy, IL 62301 Phone: 217-228-0536 Fax: 217-223-1997 | |
Shamim Amin Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5203 Broadway St, Quincy, IL 62305 Phone: 217-577-2400 | |
Donald A. Busbey D.d.s. Prof. Corp. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 N 12th St, Quincy, IL 62301 Phone: 217-222-5058 | |
Richard R Gregory Dds Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 S 20th St, Quincy, IL 62301 Phone: 217-224-0110 | |
Quincy Oral & Maxillofacial Surgery, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3915 Maine St, Suite 3, Quincy, IL 62305 Phone: 217-222-9434 Fax: 217-222-0671 |