| Cottage Dental Care Llc | |
|
2206 Cottage Ave Bloomington IL 61701-1447 | |
| (309) 828-1463 | |
| Not Available |
| Full Name | Cottage Dental Care Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2206 Cottage Ave, Bloomington, Illinois |
| Authorized Official Name and Position | Dennis R Krug (MEMBER) |
| Authorized Official Contact | 3098281463 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cottage Dental Care Llc 2206 Cottage Ave Bloomington IL 61701-1447 Ph: (309) 828-1463 | Cottage Dental Care Llc 2206 Cottage Ave Bloomington IL 61701-1447 Ph: (309) 828-1463 |
| NPI Number | 1518380070 |
|---|---|
| Provider Enumeration Date | 02/03/2014 |
| Last Update Date | 02/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518380070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019-018709 (Illinois) | Primary |
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