| Familia Dental | |
|
1403 W. Glen Peoria IL 61614 | |
| (888) 988-4066 | |
| Not Available |
| Full Name | Familia Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1403 W. Glen, Peoria, Illinois |
| Authorized Official Name and Position | Brandon Alexander Taylor (CREDENTIALING & PAYER RELATIONS) |
| Authorized Official Contact | 8474537396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Familia Dental 2050 E Algonquin Road Suite 610 Schaumburg IL 60173-4166 Ph: (847) 453-7396 | Familia Dental 1403 W. Glen Peoria IL 61614 Ph: (888) 988-4066 |
| NPI Number | 1932429164 |
|---|---|
| Provider Enumeration Date | 06/10/2010 |
| Last Update Date | 10/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932429164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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