| Prairie Dental Group | |
|
2900 Greenbriar Dr Springfield IL 62704-6418 | |
| (217) 546-0412 | |
| (217) 546-0919 |
| Full Name | Prairie Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 2900 Greenbriar Dr, Springfield, Illinois |
| Authorized Official Name and Position | Robin Hayes (OFFICE MANAGER) |
| Authorized Official Contact | 2175460412 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Dental Group 2900 Greenbriar Dr Springfield IL 62704-6418 Ph: (217) 546-0412 | Prairie Dental Group 2900 Greenbriar Dr Springfield IL 62704-6418 Ph: (217) 546-0412 |
| NPI Number | 1801517743 |
|---|---|
| Provider Enumeration Date | 09/08/2022 |
| Last Update Date | 10/04/2022 |
| Certification Date | 10/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801517743 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (NU) | Primary |
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