| Baines Dental, Llc | |
|
1112 Rickard Rd Ste A Springfield IL 62704-1021 | |
| (217) 698-9300 | |
| (217) 698-9310 |
| Full Name | Baines Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1112 Rickard Rd Ste A, Springfield, Illinois |
| Authorized Official Name and Position | Shay L Crawford (OFFICE MANAGER) |
| Authorized Official Contact | 2176989300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Baines Dental, Llc 1112 Rickard Rd Ste A Springfield IL 62704-1021 Ph: (217) 698-9300 | Baines Dental, Llc 1112 Rickard Rd Ste A Springfield IL 62704-1021 Ph: (217) 698-9300 |
| NPI Number | 1366916272 |
|---|---|
| Provider Enumeration Date | 01/14/2019 |
| Last Update Date | 01/14/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366916272 | NPI | - | NPPES |
| 1679766638 | Other | IL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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