| Robert B Davidson DDS PC | |
|
708 N Main St Elburn IL 60119-9103 | |
| (630) 365-6127 | |
| (630) 365-6128 |
| Full Name | Robert B Davidson DDS PC |
|---|---|
| Speciality | Dentist |
| Location | 708 N Main St, Elburn, Illinois |
| Authorized Official Name and Position | Robert Bruce Davidson (OWNER) |
| Authorized Official Contact | 6303656127 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert B Davidson DDS PC 708 N Main St P.o. Box 8031 Elburn IL 60119-9103 Ph: (630) 365-6127 | Robert B Davidson DDS PC 708 N Main St Elburn IL 60119-9103 Ph: (630) 365-6127 |
| NPI Number | 1063826386 |
|---|---|
| Provider Enumeration Date | 06/14/2014 |
| Last Update Date | 06/16/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063826386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019.021402 (Illinois) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | () | Secondary |
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Blackberry Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 708 N Main St, Elburn, IL 60119 Phone: 630-365-6127 |
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