| Prairie View Dental Llc | |
|
115 W Peace Rd Sycamore IL 60178 | |
| (815) 895-6100 | |
| (815) 895-6107 |
| Full Name | Prairie View Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 115 W Peace Rd, Sycamore, Illinois |
| Authorized Official Name and Position | Tiffany K Jozwiak (DENTIST OWNER) |
| Authorized Official Contact | 8158956100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie View Dental Llc 115 W Peace Rd Sycamore IL 60178 Ph: (815) 895-6100 | Prairie View Dental Llc 115 W Peace Rd Sycamore IL 60178 Ph: (815) 895-6100 |
| NPI Number | 1063570752 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063570752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Illinois) | Primary |
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