| Cu Dentist Ltd | |
|
805 West Springfield Ave Champaign IL 61820 | |
| (217) 352-5088 | |
| (217) 352-7751 |
| Full Name | Cu Dentist Ltd |
|---|---|
| Speciality | Dentist |
| Location | 805 West Springfield Ave, Champaign, Illinois |
| Authorized Official Name and Position | Robert Benjamin Scott (OWNER/PRESIDENT) |
| Authorized Official Contact | 2173525088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cu Dentist Ltd 805 West Springfield Ave Champaign IL 61820 Ph: (217) 352-5088 | Cu Dentist Ltd 805 West Springfield Ave Champaign IL 61820 Ph: (217) 352-5088 |
| NPI Number | 1942883525 |
|---|---|
| Provider Enumeration Date | 05/03/2021 |
| Last Update Date | 02/01/2024 |
| Medicare PECOS PAC ID | 1052774569 |
|---|---|
| Medicare Enrollment ID | O20230831001516 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942883525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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