| Rockfordctd Llc | |
|
1619 N Alpine Rd Rockford IL 61107-1414 | |
| (815) 229-3520 | |
| Not Available |
| Full Name | Rockfordctd Llc |
|---|---|
| Speciality | Dentist |
| Location | 1619 N Alpine Rd, Rockford, Illinois |
| Authorized Official Name and Position | Mitch Weiland (ASSISTANT CONTROLLER) |
| Authorized Official Contact | 6083430818 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rockfordctd Llc 8025 Excelsior Dr Madison WI 53717-1900 Ph: (608) 343-0818 | Rockfordctd Llc 1619 N Alpine Rd Rockford IL 61107-1414 Ph: (815) 229-3520 |
| NPI Number | 1124795240 |
|---|---|
| Provider Enumeration Date | 08/26/2021 |
| Last Update Date | 08/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124795240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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