Paul D. Potter, D.d.s., Ltd | |
280 West North St Decatur IL 62522 | |
(217) 423-3449 | |
Not Available |
Full Name | Paul D. Potter, D.d.s., Ltd |
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Speciality | Dentist |
Location | 280 West North St, Decatur, Illinois |
Authorized Official Name and Position | Paul Duane Potter (PRESIDENT) |
Authorized Official Contact | 2174233449 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Paul D. Potter, D.d.s., Ltd 280 West North St Decatur IL 62522 Ph: (217) 423-3449 | Paul D. Potter, D.d.s., Ltd 280 West North St Decatur IL 62522 Ph: (217) 423-3449 |
NPI Number | 1588808323 |
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Provider Enumeration Date | 04/23/2009 |
Last Update Date | 04/23/2009 |
Identifier | Type | State | Issuer |
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1588808323 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 19-017-257 (Illinois) | Primary |
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