| Affordable Dental Of Illinois | |
|
195 S Main St Dupo IL 62239-1347 | |
| (618) 286-4400 | |
| Not Available |
| Full Name | Affordable Dental Of Illinois |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 195 S Main St, Dupo, Illinois |
| Authorized Official Name and Position | Ronald D Gersten (OWNER) |
| Authorized Official Contact | 6182864400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Affordable Dental Of Illinois 195 S Main St Dupo IL 62239-1347 Ph: () - | Affordable Dental Of Illinois 195 S Main St Dupo IL 62239-1347 Ph: (618) 286-4400 |
| NPI Number | 1063552453 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063552453 | NPI | - | NPPES |
| 1004673 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Illinois) | Primary |
Affordable Dental Of Illnois Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 195 S Main St, Dupo, IL 62239 Phone: 312-800-1270 | |
Affordable Dentistry Of Il Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 195 S Main St, Dupo, IL 62239 Phone: 618-286-4400 |