| Fieldcrest Dental, P.c. | |
|
203 E Santa Fe Ave Toluca IL 61369 | |
| (815) 452-2513 | |
| Not Available |
| Full Name | Fieldcrest Dental, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 203 E Santa Fe Ave, Toluca, Illinois |
| Authorized Official Name and Position | Patrick Hamper (SHAREHOLDER) |
| Authorized Official Contact | 8154522513 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fieldcrest Dental, P.c. 203 E Santa Fe Ave Toluca IL 61369 Ph: () - | Fieldcrest Dental, P.c. 203 E Santa Fe Ave Toluca IL 61369 Ph: (815) 452-2513 |
| NPI Number | 1275879918 |
|---|---|
| Provider Enumeration Date | 12/28/2012 |
| Last Update Date | 12/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275879918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019027745 (Illinois) | Primary |
S B Naik Dds Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 E Santa Fe, Box 674, Toluca, IL 61369 Phone: 815-452-2513 Fax: 815-452-2585 |