Mclean County Dental | |
2103 E Washington St Suite 1c Bloomington IL 61701-4310 | |
(309) 662-8448 | |
(309) 662-7617 |
Full Name | Mclean County Dental |
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Speciality | Dentist - General Practice |
Location | 2103 E Washington St, Bloomington, Illinois |
Authorized Official Name and Position | Emil M. Verban (OWNER) |
Authorized Official Contact | 3096628448 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mclean County Dental 2103 E Washington St Suite 1c Bloomington IL 61701-4310 Ph: (309) 662-8448 | Mclean County Dental 2103 E Washington St Suite 1c Bloomington IL 61701-4310 Ph: (309) 662-8448 |
NPI Number | 1417216870 |
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Provider Enumeration Date | 05/04/2012 |
Last Update Date | 05/04/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417216870 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 019015656 (Illinois) | Primary |
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