Justin T. Durancik, Dds, Pllc | |
619 E Main St Genoa IL 60135-1309 | |
(815) 784-5166 | |
Not Available |
Full Name | Justin T. Durancik, Dds, Pllc |
---|---|
Speciality | Clinic/center - Dental |
Location | 619 E Main St, Genoa, Illinois |
Authorized Official Name and Position | Justin Tyler Durancik (DENTIST) |
Authorized Official Contact | 8157617159 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Justin T. Durancik, Dds, Pllc 16488 E Mcneal Rd Monroe Center IL 61052-9719 Ph: (815) 761-7159 | Justin T. Durancik, Dds, Pllc 619 E Main St Genoa IL 60135-1309 Ph: (815) 784-5166 |
NPI Number | 1932683315 |
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Provider Enumeration Date | 09/20/2018 |
Last Update Date | 09/20/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932683315 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Genoa Smiles Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 619 E Main St, Genoa, IL 60135 Phone: 815-784-5166 Fax: 815-784-5167 |