| Secure Dental LLC | |
|
3127 N. University St. Peoria IL 61604 | |
| (309) 681-8888 | |
| Not Available |
| Full Name | Secure Dental LLC |
|---|---|
| Speciality | Dentist |
| Location | 3127 N. University St., Peoria, Illinois |
| Authorized Official Name and Position | Noel Liu (MEMBER) |
| Authorized Official Contact | 8156702923 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Secure Dental LLC 1695 Divine Dr Rockford IL 61107-5417 Ph: (815) 670-2923 | Secure Dental LLC 3127 N. University St. Peoria IL 61604 Ph: (309) 681-8888 |
| NPI Number | 1154607422 |
|---|---|
| Provider Enumeration Date | 10/31/2011 |
| Last Update Date | 01/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154607422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019027468 (Illinois) | Primary |
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