| Pediatric Dental Associates Of Mclean County, Inc | |
|
211 S Prospect Rd Bloomington IL 61704-4910 | |
| (309) 663-7339 | |
| (309) 663-7131 |
| Full Name | Pediatric Dental Associates Of Mclean County, Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 211 S Prospect Rd, Bloomington, Illinois |
| Authorized Official Name and Position | Sara R Rauen Dardis (PEDIATRIC DENTIST) |
| Authorized Official Contact | 3096637339 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dental Associates Of Mclean County, Inc 211 S Prospect Rd Bloomington IL 61704-4910 Ph: (309) 663-7339 | Pediatric Dental Associates Of Mclean County, Inc 211 S Prospect Rd Bloomington IL 61704-4910 Ph: (309) 663-7339 |
| NPI Number | 1982878708 |
|---|---|
| Provider Enumeration Date | 04/14/2008 |
| Last Update Date | 04/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982878708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Illinois) | Primary |
| 261QD0000X | Clinic/center - Dental | (Illinois) | Secondary |
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Robert D. Horenkamp, D.d.s. P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 405 S Prospect Rd, Bloomington, IL 61704 Phone: 309-662-2833 Fax: 309-662-7862 | |
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