| Modern Dental Of Rockford Llc | |
|
1321 Sandy Hollow Rd Rockford IL 61109-2120 | |
| (815) 209-9070 | |
| Not Available |
| Full Name | Modern Dental Of Rockford Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1321 Sandy Hollow Rd, Rockford, Illinois |
| Authorized Official Name and Position | Jeff Thomas (PRESIDENT) |
| Authorized Official Contact | 6185324902 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Dental Of Rockford Llc 1321 Sandy Hollow Rd Rockford IL 61109-2120 Ph: (815) 209-9070 | Modern Dental Of Rockford Llc 1321 Sandy Hollow Rd Rockford IL 61109-2120 Ph: (815) 209-9070 |
| NPI Number | 1346563525 |
|---|---|
| Provider Enumeration Date | 03/02/2010 |
| Last Update Date | 03/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346563525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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