| Crystal Lake Dental Associates | |
|
280 Memorial Ct Ste B Crystal Lake IL 60014-6233 | |
| (815) 459-2202 | |
| (815) 459-2787 |
| Full Name | Crystal Lake Dental Associates |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 280 Memorial Ct Ste B, Crystal Lake, Illinois |
| Authorized Official Name and Position | Phillip C Neal (PRESIDENT) |
| Authorized Official Contact | 8154599389 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal Lake Dental Associates 122 Dole Ave Crystal Lake IL 60014-5840 Ph: (815) 459-9389 | Crystal Lake Dental Associates 280 Memorial Ct Ste B Crystal Lake IL 60014-6233 Ph: (815) 459-2202 |
| NPI Number | 1871702985 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871702985 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 1915895 (Illinois) | Primary |
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