| Dr. Paul & Dr. Anderson, Dental Pc | |
|
521 W Lake Ave Peoria IL 61614-6020 | |
| (309) 682-0770 | |
| Not Available |
| Full Name | Dr. Paul & Dr. Anderson, Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 521 W Lake Ave, Peoria, Illinois |
| Authorized Official Name and Position | Roger Paul (DENTIST) |
| Authorized Official Contact | 3096820770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Paul & Dr. Anderson, Dental Pc 521 W. Lake Ave Peoria IL 61614 Ph: (309) 682-0770 | Dr. Paul & Dr. Anderson, Dental Pc 521 W Lake Ave Peoria IL 61614-6020 Ph: (309) 682-0770 |
| NPI Number | 1154728228 |
|---|---|
| Provider Enumeration Date | 12/04/2014 |
| Last Update Date | 12/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154728228 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1916423 (Illinois) | Primary |
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