| Houska Dental Center, Llc | |
|
2433 Maloney Dr Bloomington IL 61704-3750 | |
| (309) 662-9042 | |
| Not Available |
| Full Name | Houska Dental Center, Llc |
|---|---|
| Speciality | Dentist |
| Location | 2433 Maloney Dr, Bloomington, Illinois |
| Authorized Official Name and Position | Mark Houska (OWNER) |
| Authorized Official Contact | 3096629042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Houska Dental Center, Llc 2433 Maloney Dr Bloomington IL 61704-3750 Ph: () - | Houska Dental Center, Llc 2433 Maloney Dr Bloomington IL 61704-3750 Ph: (309) 662-9042 |
| NPI Number | 1235486762 |
|---|---|
| Provider Enumeration Date | 08/15/2012 |
| Last Update Date | 08/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235486762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019020622 (Illinois) | Primary |
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