| Mark Benavides D.D.S., P.C. | |
|
1703 Polaris Cir Ottawa IL 61350-1683 | |
| (815) 434-0152 | |
| Not Available |
| Full Name | Mark Benavides D.D.S., P.C. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1703 Polaris Cir, Ottawa, Illinois |
| Authorized Official Name and Position | Mark Benavides (OWNER) |
| Authorized Official Contact | 8154340152 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Benavides D.D.S., P.C. 1703 Polaris Cir Ottawa IL 61350-1683 Ph: (815) 434-0152 | Mark Benavides D.D.S., P.C. 1703 Polaris Cir Ottawa IL 61350-1683 Ph: (815) 434-0152 |
| NPI Number | 1235201344 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 12/17/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235201344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0019-20337 (Illinois) | Primary |
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