Midlothian Family Dental Ltd. | |
4155 147th St Midlothian IL 60445-3368 | |
(630) 926-3920 | |
Not Available |
Full Name | Midlothian Family Dental Ltd. |
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Speciality | Clinic/center - Dental |
Location | 4155 147th St, Midlothian, Illinois |
Authorized Official Name and Position | Mark Francis Ploskonka (PRESIDENT) |
Authorized Official Contact | 6309263920 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Midlothian Family Dental Ltd. 1818 Kelly Ct Darien IL 60561-5600 Ph: (630) 926-3920 | Midlothian Family Dental Ltd. 4155 147th St Midlothian IL 60445-3368 Ph: (630) 926-3920 |
NPI Number | 1265947212 |
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Provider Enumeration Date | 12/12/2017 |
Last Update Date | 12/12/2017 |
Identifier | Type | State | Issuer |
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1265947212 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | 019021645 (Illinois) | Primary |