| Innovative Dental Care Of Shorewood | |
|
1526 Il Route 59 Joliet IL 60431-8215 | |
| (815) 436-8787 | |
| Not Available |
| Full Name | Innovative Dental Care Of Shorewood |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1526 Il Route 59, Joliet, Illinois |
| Authorized Official Name and Position | Belinda Huerta (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175402100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Dental Care Of Shorewood 1526 Il Route 59 Joliet IL 60431-8215 Ph: () - | Innovative Dental Care Of Shorewood 1526 Il Route 59 Joliet IL 60431-8215 Ph: (815) 436-8787 |
| NPI Number | 1851971642 |
|---|---|
| Provider Enumeration Date | 04/14/2021 |
| Last Update Date | 06/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851971642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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