| Maple Shade Dental Group | |
|
11825 N Knoxville Ave Dunlap IL 61525 | |
| (309) 243-7702 | |
| (309) 243-9559 |
| Full Name | Maple Shade Dental Group |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 11825 N Knoxville Ave, Dunlap, Illinois |
| Authorized Official Name and Position | Rodney Earl Willey (CEO) |
| Authorized Official Contact | 3092437702 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maple Shade Dental Group 11825 N Knoxville Ave Dunlap IL 61525 Ph: (309) 243-7702 | Maple Shade Dental Group 11825 N Knoxville Ave Dunlap IL 61525 Ph: (309) 243-7702 |
| NPI Number | 1427116854 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 09/11/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427116854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Secondary |
| 1223P0300X | Dentist - Periodontics | () | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | () | Primary |
Maple Shade Dental (dunlap) LLC Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11825 State Route 40, Suite 200, Dunlap, IL 61525 Phone: 309-243-7702 Fax: 309-243-9061 |
Koala Center for Sleep & Tmj Disorders Mi-1 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11825 State Route 40, Suite 100, Dunlap, IL 61525 Phone: 309-839-9971 Fax: 309-807-3365 |
Illinois Institute of Dental Sleep Medicine Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11825 State Route 40 Ste 100, Dunlap, IL 61525 Phone: 309-243-8980 |
Illinois Institute of Dental Sleep Medicine PLLC Dental Clinic Medicare: Medicare Enrolled Practice Location: 11825 State Route 40 # 100, Dunlap, IL 61525 Phone: 309-243-8980 Fax: 866-474-4113 |
Jet Dental of Illinois, PLLC Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11825 N Knoxville Ave Ste 1a, Dunlap, IL 61525 Phone: 972-369-2684 |