| Paul D. Potter, D.D.S., Ltd | |
|
280 West North St Decatur IL 62522 | |
| (217) 423-3449 | |
| Not Available |
| Full Name | Paul D. Potter, D.D.S., Ltd |
|---|---|
| Speciality | Dentist |
| Location | 280 West North St, Decatur, Illinois |
| Authorized Official Name and Position | Paul Duane Potter (PRESIDENT) |
| Authorized Official Contact | 2174233449 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul D. Potter, D.D.S., Ltd 280 West North St Decatur IL 62522 Ph: (217) 423-3449 | Paul D. Potter, D.D.S., Ltd 280 West North St Decatur IL 62522 Ph: (217) 423-3449 |
| NPI Number | 1588808323 |
|---|---|
| Provider Enumeration Date | 04/23/2009 |
| Last Update Date | 04/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588808323 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 19-017-257 (Illinois) | Primary |
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