| Lifetime Dental Care Of Illinois, Pc | |
|
411 Keokuk Street Lincoln IL 62656 | |
| (217) 732-8818 | |
| (217) 732-9703 |
| Full Name | Lifetime Dental Care Of Illinois, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 411 Keokuk Street, Lincoln, Illinois |
| Authorized Official Name and Position | Amy Kroeger (INS COOD) |
| Authorized Official Contact | 2175405100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetime Dental Care Of Illinois, Pc 411 Keokuk Street Lincoln IL 62656 Ph: (217) 732-8818 | Lifetime Dental Care Of Illinois, Pc 411 Keokuk Street Lincoln IL 62656 Ph: (217) 732-8818 |
| NPI Number | 1720290638 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 05/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720290638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |