| Lavender Rose Dental | |
|
333 N Morehead St Chenoa IL 61726-1001 | |
| (815) 945-7808 | |
| Not Available |
| Full Name | Lavender Rose Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 333 N Morehead St, Chenoa, Illinois |
| Authorized Official Name and Position | Shima Phoenix (DENTIST) |
| Authorized Official Contact | 5758404838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lavender Rose Dental 333 N Morehead St Chenoa IL 61726-1001 Ph: () - | Lavender Rose Dental 333 N Morehead St Chenoa IL 61726-1001 Ph: (815) 945-7808 |
| NPI Number | 1902412158 |
|---|---|
| Provider Enumeration Date | 09/22/2020 |
| Last Update Date | 09/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902412158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |