Pana Family Dental | |
128 S Locust St Pana IL 62557-1430 | |
(217) 562-3330 | |
Not Available |
Full Name | Pana Family Dental |
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Speciality | Clinic/center - Dental |
Location | 128 S Locust St, Pana, Illinois |
Authorized Official Name and Position | Kelly Clark (PRESIDENT) |
Authorized Official Contact | 2175623330 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pana Family Dental 128 S Locust St Pana IL 62557-1430 Ph: () - | Pana Family Dental 128 S Locust St Pana IL 62557-1430 Ph: (217) 562-3330 |
NPI Number | 1598193153 |
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Provider Enumeration Date | 10/17/2013 |
Last Update Date | 10/17/2013 |
Identifier | Type | State | Issuer |
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1598193153 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | 019026315 (Illinois) | Primary |