| Lonn E Brander Dds Ltd | |
|
203 N 2nd St Dekalb IL 60115-3234 | |
| (815) 756-2295 | |
| Not Available |
| Full Name | Lonn E Brander Dds Ltd |
|---|---|
| Speciality | Dentist |
| Location | 203 N 2nd St, Dekalb, Illinois |
| Authorized Official Name and Position | Lonn Edward Brander (DENTIST/ OWNER) |
| Authorized Official Contact | 8157562295 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lonn E Brander Dds Ltd 203 N 2nd St Dekalb IL 60115-3234 Ph: (815) 756-2295 | Lonn E Brander Dds Ltd 203 N 2nd St Dekalb IL 60115-3234 Ph: (815) 756-2295 |
| NPI Number | 1457694853 |
|---|---|
| Provider Enumeration Date | 04/03/2013 |
| Last Update Date | 04/02/2014 |
| Medicare PECOS PAC ID | 9032340773 |
|---|---|
| Medicare Enrollment ID | O20140324000504 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457694853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019-022322 (Illinois) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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