| Illinois Dental Providers, P. C. | |
|
12720 S Route 59 Suite 200 Plainfield IL 60585-5505 | |
| (972) 755-0883 | |
| (216) 584-1750 |
| Full Name | Illinois Dental Providers, P. C. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12720 S Route 59, Plainfield, Illinois |
| Authorized Official Name and Position | Rachel Nittinger (MANAGER CREDENTIALING) |
| Authorized Official Contact | 9727550816 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illinois Dental Providers, P. C. 7160 Dallas Pkwy Ste 400 Plano TX 75024-7111 Ph: () - | Illinois Dental Providers, P. C. 12720 S Route 59 Suite 200 Plainfield IL 60585-5505 Ph: (972) 755-0883 |
| NPI Number | 1659821312 |
|---|---|
| Provider Enumeration Date | 10/06/2016 |
| Last Update Date | 03/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659821312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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