| Colorado Dental Professionals, Llc | |
|
1200 Network Centre Dr Effingham IL 62401-4602 | |
| (217) 540-5100 | |
| Not Available |
| Full Name | Colorado Dental Professionals, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1200 Network Centre Dr, Effingham, Illinois |
| Authorized Official Name and Position | Cassandra Petersen (CREDENTIALING TEAM LEAD) |
| Authorized Official Contact | 2175408972 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colorado Dental Professionals, Llc 1200 Network Centre Dr Effingham IL 62401-4602 Ph: (217) 540-5100 | Colorado Dental Professionals, Llc 1200 Network Centre Dr Effingham IL 62401-4602 Ph: (217) 540-5100 |
| NPI Number | 1932609096 |
|---|---|
| Provider Enumeration Date | 02/15/2018 |
| Last Update Date | 02/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932609096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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