| Illini Smiles Dental Care Pc | |
|
303 W Springfield Ave Champaign IL 61820-4817 | |
| (217) 356-3335 | |
| Not Available |
| Full Name | Illini Smiles Dental Care Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 303 W Springfield Ave, Champaign, Illinois |
| Authorized Official Name and Position | Yudong Xu (ONWER) |
| Authorized Official Contact | 2173563335 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illini Smiles Dental Care Pc 303 W Springfield Ave Champaign IL 61820-4817 Ph: (217) 356-3335 | Illini Smiles Dental Care Pc 303 W Springfield Ave Champaign IL 61820-4817 Ph: (217) 356-3335 |
| NPI Number | 1891245957 |
|---|---|
| Provider Enumeration Date | 10/12/2016 |
| Last Update Date | 10/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891245957 | NPI | - | NPPES |
| 9178971 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019026810 (Illinois) | Primary |
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