| Mlb Dental, Ltd. | |
|
333 Circle Ave Forest Park IL 60130-3624 | |
| (708) 771-0330 | |
| (708) 771-4076 |
| Full Name | Mlb Dental, Ltd. |
|---|---|
| Speciality | Dentist |
| Location | 333 Circle Ave, Forest Park, Illinois |
| Authorized Official Name and Position | Marlene Lynn Beeson (OWNER/PRESIDENT) |
| Authorized Official Contact | 6309159510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mlb Dental, Ltd. 333 Circle Ave Forest Park IL 60130-3624 Ph: (708) 771-0330 | Mlb Dental, Ltd. 333 Circle Ave Forest Park IL 60130-3624 Ph: (708) 771-0330 |
| NPI Number | 1366731580 |
|---|---|
| Provider Enumeration Date | 03/29/2011 |
| Last Update Date | 03/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366731580 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019.027066 (Illinois) | Primary |
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