| Dental Sealants & More | |
|
2126 N. University St. Peoria IL 61604 | |
| (309) 339-4433 | |
| (309) 406-1326 |
| Full Name | Dental Sealants & More |
|---|---|
| Speciality | Dentist |
| Location | 2126 N. University St., Peoria, Illinois |
| Authorized Official Name and Position | Renee Katherine Dietz (PRESIDENT) |
| Authorized Official Contact | 3093394433 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Sealants & More 2126 N. University St. Peoria IL 61604 Ph: (309) 339-4433 | Dental Sealants & More 2126 N. University St. Peoria IL 61604 Ph: (309) 339-4433 |
| NPI Number | 1770755852 |
|---|---|
| Provider Enumeration Date | 03/28/2008 |
| Last Update Date | 02/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770755852 | NPI | - | NPPES |
| 1001319 | Other | IL | DORAL DENTAL OF ILLINOIS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019-010639 (Illinois) | Primary |
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