| Scm Dental Pc | |
|
2435 Glenwood Ave Joliet IL 60435-5461 | |
| (815) 725-0260 | |
| (815) 729-2126 |
| Full Name | Scm Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2435 Glenwood Ave, Joliet, Illinois |
| Authorized Official Name and Position | Sonal C Mehta (OWNER/PRESIDENT) |
| Authorized Official Contact | 8157250260 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Scm Dental Pc 2400 Glenwood Ave Suite 225 Joliet IL 60435-5474 Ph: (815) 725-0260 | Scm Dental Pc 2435 Glenwood Ave Joliet IL 60435-5461 Ph: (815) 725-0260 |
| NPI Number | 1609136373 |
|---|---|
| Provider Enumeration Date | 05/29/2012 |
| Last Update Date | 03/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609136373 | NPI | - | NPPES |
| 421529687 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019027726 (Illinois) | Primary |
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