| Mark J Maly Estate | |
|
103 S Main St # Po Orangeville IL 61060-9244 | |
| (815) 789-4611 | |
| Not Available |
| Full Name | Mark J Maly Estate |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 103 S Main St # Po, Orangeville, Illinois |
| Authorized Official Name and Position | Penny Bose (OFFICE MANAGER) |
| Authorized Official Contact | 8157894611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark J Maly Estate Po Box 456 Orangeville IL 61060-0456 Ph: (815) 789-4611 | Mark J Maly Estate 103 S Main St # Po Orangeville IL 61060-9244 Ph: (815) 789-4611 |
| NPI Number | 1649883364 |
|---|---|
| Provider Enumeration Date | 08/24/2020 |
| Last Update Date | 08/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649883364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Verheecke Dental Llc Dental Clinic Medicare: Medicare Enrolled Practice Location: 103 S Main St, Orangeville, IL 61060 Phone: 815-789-4611 Fax: 815-789-4612 |