| Genoa Smiles | |
|
619 E Main St Genoa IL 60135-1309 | |
| (815) 784-5166 | |
| (815) 784-5167 |
| Full Name | Genoa Smiles |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 619 E Main St, Genoa, Illinois |
| Authorized Official Name and Position | David N Mcauslan (OWNER/ DENTIST) |
| Authorized Official Contact | 8157845166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genoa Smiles 619 E Main St Genoa IL 60135-1309 Ph: (815) 784-5166 | Genoa Smiles 619 E Main St Genoa IL 60135-1309 Ph: (815) 784-5166 |
| NPI Number | 1215377031 |
|---|---|
| Provider Enumeration Date | 06/25/2013 |
| Last Update Date | 06/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215377031 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019017239 (Illinois) | Primary |
Justin T. Durancik, Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 619 E Main St, Genoa, IL 60135 Phone: 815-784-5166 |