| Park Avenue Dental Professionals, Pc | |
|
1001 W. Park Avenue Libertyville IL 60048 | |
| (847) 918-1255 | |
| Not Available |
| Full Name | Park Avenue Dental Professionals, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1001 W. Park Avenue, Libertyville, Illinois |
| Authorized Official Name and Position | Meggan Rutledge (OWNER) |
| Authorized Official Contact | 8479181255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Avenue Dental Professionals, Pc 1001 W Park Ave Libertyville IL 60048-2550 Ph: (847) 918-1255 | Park Avenue Dental Professionals, Pc 1001 W. Park Avenue Libertyville IL 60048 Ph: (847) 918-1255 |
| NPI Number | 1184119950 |
|---|---|
| Provider Enumeration Date | 06/25/2018 |
| Last Update Date | 06/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184119950 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019029777 (Illinois) | Primary |
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