| Antioch Dental Centre Pc | |
|
439 Lake St Antioch IL 60002-1405 | |
| (847) 395-3250 | |
| Not Available |
| Full Name | Antioch Dental Centre Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 439 Lake St, Antioch, Illinois |
| Authorized Official Name and Position | Kenneth Arthur Johnson (PRESIDENT) |
| Authorized Official Contact | 8473953250 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Antioch Dental Centre Pc 439 Lake St Antioch IL 60002-1405 Ph: (847) 395-3250 | Antioch Dental Centre Pc 439 Lake St Antioch IL 60002-1405 Ph: (847) 395-3250 |
| NPI Number | 1972368116 |
|---|---|
| Provider Enumeration Date | 02/16/2024 |
| Last Update Date | 03/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972368116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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