| Andris Family Dental, Llc | |
|
636 W Jefferson St Morton IL 61550-1581 | |
| (309) 263-8317 | |
| (309) 263-2175 |
| Full Name | Andris Family Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 636 W Jefferson St, Morton, Illinois |
| Authorized Official Name and Position | Ryan Wayne Andris (DENTIST/OWNER) |
| Authorized Official Contact | 3092638317 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Andris Family Dental, Llc 636 W Jefferson St Morton IL 61550-1581 Ph: (309) 263-8317 | Andris Family Dental, Llc 636 W Jefferson St Morton IL 61550-1581 Ph: (309) 263-8317 |
| NPI Number | 1225493034 |
|---|---|
| Provider Enumeration Date | 12/21/2015 |
| Last Update Date | 12/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225493034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019.029393 (Illinois) | Primary |
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