New Day Family Dental Llc | |
5899 N Belt W Belleville IL 62226-4600 | |
(618) 222-8887 | |
Not Available |
Full Name | New Day Family Dental Llc |
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Speciality | Dentist |
Location | 5899 N Belt W, Belleville, Illinois |
Authorized Official Name and Position | Forrest Farr (OWNER) |
Authorized Official Contact | 6182228887 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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New Day Family Dental Llc 5899 N Belt W Belleville IL 62226-4600 Ph: (618) 222-8887 | New Day Family Dental Llc 5899 N Belt W Belleville IL 62226-4600 Ph: (618) 222-8887 |
NPI Number | 1013288703 |
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Provider Enumeration Date | 01/26/2012 |
Last Update Date | 06/05/2014 |
Medicare PECOS PAC ID | 1759507155 |
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Medicare Enrollment ID | O20140721001473 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013288703 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 019026486 (Illinois) | Primary |
122300000X | Dentist | 019026532 (Illinois) | Secondary |
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