| Innovative Orthodontics | |
|
1000 W Jefferson St Ste 101 Joliet IL 60435-6812 | |
| (814) 727-5813 | |
| Not Available |
| Full Name | Innovative Orthodontics |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1000 W Jefferson St Ste 101, Joliet, Illinois |
| Authorized Official Name and Position | John Alvan Gordon (TREASURER) |
| Authorized Official Contact | 6308780351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Orthodontics 1905 Marketview Dr Unit 274 Yorkville IL 60560-1896 Ph: (630) 878-0351 | Innovative Orthodontics 1000 W Jefferson St Ste 101 Joliet IL 60435-6812 Ph: (814) 727-5813 |
| NPI Number | 1700207594 |
|---|---|
| Provider Enumeration Date | 12/20/2013 |
| Last Update Date | 12/23/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700207594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019020648 (Illinois) | Primary |
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