| Mill Creek Dental Care | |
|
39w250 Herrington Blvd Suite F1 Geneva IL 60134-6192 | |
| (630) 208-0051 | |
| Not Available |
| Full Name | Mill Creek Dental Care |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 39w250 Herrington Blvd, Geneva, Illinois |
| Authorized Official Name and Position | Timothy Emerson Skidmore (PRESIDENT) |
| Authorized Official Contact | 6302080051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mill Creek Dental Care 39w250 Herrington Blvd Suite F1 Geneva IL 60134-6192 Ph: (630) 208-0051 | Mill Creek Dental Care 39w250 Herrington Blvd Suite F1 Geneva IL 60134-6192 Ph: (630) 208-0051 |
| NPI Number | 1902061344 |
|---|---|
| Provider Enumeration Date | 07/24/2008 |
| Last Update Date | 07/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902061344 | NPI | - | NPPES |
| 189948 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019025894 (Illinois) | Primary |
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