| Dexter Dental Llc | |
|
47 Clock Tower Plaza Elgin IL 60120-7800 | |
| (847) 695-8780 | |
| (847) 695-0939 |
| Full Name | Dexter Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 47 Clock Tower Plaza, Elgin, Illinois |
| Authorized Official Name and Position | Brandon Alexander Taylor (CREDENTIALING & PAYER RELATIONS MAN) |
| Authorized Official Contact | 8474537396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dexter Dental Llc 2050 East Algonquin Road Suite 610 Schaumburg IL 60173-4166 Ph: (847) 453-7396 | Dexter Dental Llc 47 Clock Tower Plaza Elgin IL 60120-7800 Ph: (847) 695-8780 |
| NPI Number | 1942462080 |
|---|---|
| Provider Enumeration Date | 06/30/2008 |
| Last Update Date | 06/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942462080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019026920 (Illinois) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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