| Boulder Hill Dental Associates | |
|
20 Boulder Hill Pass Montgomery IL 60538-1951 | |
| (630) 896-5013 | |
| (630) 896-5108 |
| Full Name | Boulder Hill Dental Associates |
|---|---|
| Speciality | Dentist |
| Location | 20 Boulder Hill Pass, Montgomery, Illinois |
| Authorized Official Name and Position | Mark R Commean (DENTIST OWNER) |
| Authorized Official Contact | 6308965013 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boulder Hill Dental Associates 20 Boulder Hill Pass Montgomery IL 60538-1951 Ph: (630) 896-5013 | Boulder Hill Dental Associates 20 Boulder Hill Pass Montgomery IL 60538-1951 Ph: (630) 896-5013 |
| NPI Number | 1417046905 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417046905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 01914998 (Illinois) | Secondary |
| 122300000X | Dentist | (Illinois) | Primary |
| 122300000X | Dentist | (Illinois) | Secondary |
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