| Midlothian Family Dental Ltd. | |
|
4155 147th St Midlothian IL 60445-3368 | |
| (630) 926-3920 | |
| Not Available |
| Full Name | Midlothian Family Dental Ltd. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4155 147th St, Midlothian, Illinois |
| Authorized Official Name and Position | Mark Francis Ploskonka (PRESIDENT) |
| Authorized Official Contact | 6309263920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midlothian Family Dental Ltd. 1818 Kelly Ct Darien IL 60561-5600 Ph: (630) 926-3920 | Midlothian Family Dental Ltd. 4155 147th St Midlothian IL 60445-3368 Ph: (630) 926-3920 |
| NPI Number | 1265947212 |
|---|---|
| Provider Enumeration Date | 12/12/2017 |
| Last Update Date | 12/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265947212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019021645 (Illinois) | Primary |