| Mchenry Dental Center, Ltd. | |
|
1315 N Riverside Dr Mchenry IL 60050-4509 | |
| (815) 385-1360 | |
| (815) 385-3879 |
| Full Name | Mchenry Dental Center, Ltd. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1315 N Riverside Dr, Mchenry, Illinois |
| Authorized Official Name and Position | Thomas Gough (PRESIDENT) |
| Authorized Official Contact | 8153851360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mchenry Dental Center, Ltd. 1315 N Riverside Dr Mchenry IL 60050-4509 Ph: (815) 385-1360 | Mchenry Dental Center, Ltd. 1315 N Riverside Dr Mchenry IL 60050-4509 Ph: (815) 385-1360 |
| NPI Number | 1083811483 |
|---|---|
| Provider Enumeration Date | 06/28/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083811483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |
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