| Mys-roscoe Llc | |
|
5416 Reimer Drive Roscoe IL 61073 | |
| (815) 398-3879 | |
| Not Available |
| Full Name | Mys-roscoe Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5416 Reimer Drive, Roscoe, Illinois |
| Authorized Official Name and Position | Todd Stern (OWNER) |
| Authorized Official Contact | 8153983879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mys-roscoe Llc 1110 S Mulford Rd Rockford IL 61108-4213 Ph: (815) 988-1993 | Mys-roscoe Llc 5416 Reimer Drive Roscoe IL 61073 Ph: (815) 398-3879 |
| NPI Number | 1073340766 |
|---|---|
| Provider Enumeration Date | 09/17/2024 |
| Last Update Date | 09/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073340766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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