| Shady Oak Dental - Byron Dental Llc | |
|
503 W Blackhawk Dr Byron IL 61010-9647 | |
| (309) 369-3284 | |
| Not Available |
| Full Name | Shady Oak Dental - Byron Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 503 W Blackhawk Dr, Byron, Illinois |
| Authorized Official Name and Position | Scott Bares (PRESIDENT) |
| Authorized Official Contact | 8152752680 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shady Oak Dental - Byron Dental Llc 1342 S Harlem Ave Freeport IL 61032-6231 Ph: (309) 369-3284 | Shady Oak Dental - Byron Dental Llc 503 W Blackhawk Dr Byron IL 61010-9647 Ph: (309) 369-3284 |
| NPI Number | 1871463760 |
|---|---|
| Provider Enumeration Date | 11/06/2025 |
| Last Update Date | 11/06/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871463760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Bonvallet Dental, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 N Walnut St, Byron, IL 61010 Phone: 815-234-4211 |