| Kankakee Dental Pllc | |
|
200 E Court St Ste 504 Kankakee IL 60901-3847 | |
| (815) 932-3613 | |
| Not Available |
| Full Name | Kankakee Dental Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 200 E Court St Ste 504, Kankakee, Illinois |
| Authorized Official Name and Position | Kevin Fatland (MEMBER) |
| Authorized Official Contact | 7089907869 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kankakee Dental Pllc 200 E Court St Ste 504 Kankakee IL 60901-3847 Ph: (815) 932-3613 | Kankakee Dental Pllc 200 E Court St Ste 504 Kankakee IL 60901-3847 Ph: (815) 932-3613 |
| NPI Number | 1780256503 |
|---|---|
| Provider Enumeration Date | 07/12/2021 |
| Last Update Date | 07/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780256503 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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Kankakee School District 111 School-based Health Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2250 E Crestwood St, Kankakee, IL 60901 Phone: 815-933-0772 Fax: 815-933-6730 | |
Syreeta C Jones Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 986 E Court St, Kankakee, IL 60901 Phone: 815-325-2613 | |
Al Weatherford Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 E Court St, Suite 504, Kankakee, IL 60901 Phone: 815-932-3613 | |
John T Peterson Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 E Court St, Suite 504, Kankakee, IL 60901 Phone: 815-932-3613 | |
Donald E Krause Dds Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 555 W Court St, Suite 102, Kankakee, IL 60901 Phone: 815-937-3521 Fax: 815-802-1264 | |
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