| Long Creek Dental | |
|
3040 S Mount Zion Rd Decatur IL 62521-9771 | |
| (217) 864-4494 | |
| Not Available |
| Full Name | Long Creek Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3040 S Mount Zion Rd, Decatur, Illinois |
| Authorized Official Name and Position | Heather Pruemer (CREDENTIALING TEAM LEAD) |
| Authorized Official Contact | 2175408434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Creek Dental 3040 S Mount Zion Rd Decatur IL 62521-9771 Ph: () - | Long Creek Dental 3040 S Mount Zion Rd Decatur IL 62521-9771 Ph: (217) 864-4494 |
| NPI Number | 1720531759 |
|---|---|
| Provider Enumeration Date | 07/26/2016 |
| Last Update Date | 07/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720531759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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