| Freeport Dental | |
|
1450 S West Ave Freeport IL 61032-6351 | |
| (815) 656-4060 | |
| (815) 656-2324 |
| Full Name | Freeport Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1450 S West Ave, Freeport, Illinois |
| Authorized Official Name and Position | Scott Bares (OWNER) |
| Authorized Official Contact | 8156564060 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Freeport Dental 1450 S West Ave Freeport IL 61032-6351 Ph: (815) 656-4060 | Freeport Dental 1450 S West Ave Freeport IL 61032-6351 Ph: (815) 656-4060 |
| NPI Number | 1891165643 |
|---|---|
| Provider Enumeration Date | 10/05/2015 |
| Last Update Date | 10/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891165643 | NPI | - | NPPES |
| 1164580734 | Other | GENERAL DENISTRY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019027024 (Illinois) | Primary |
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