| Willow Festival Dental | |
|
840 Willow Rd Ste H Northbrook IL 60062-6823 | |
| (847) 559-9550 | |
| (847) 559-9560 |
| Full Name | Willow Festival Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 840 Willow Rd Ste H, Northbrook, Illinois |
| Authorized Official Name and Position | Joshua Harper Prompton (DENTIST/OWNER) |
| Authorized Official Contact | 8326001069 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Festival Dental 840 Willow Rd Ste H Northbrook IL 60062-6823 Ph: (847) 559-9550 | Willow Festival Dental 840 Willow Rd Ste H Northbrook IL 60062-6823 Ph: (847) 559-9550 |
| NPI Number | 1477137644 |
|---|---|
| Provider Enumeration Date | 05/12/2021 |
| Last Update Date | 05/12/2021 |
| Certification Date | 05/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477137644 | NPI | - | NPPES |
| 1316402910 | Other | IL | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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