| Pediatric Dentistry Ltd | |
|
860 Summit St Suite 246 Elgin IL 60120-5145 | |
| (847) 695-1693 | |
| (847) 695-9212 |
| Full Name | Pediatric Dentistry Ltd |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 860 Summit St, Elgin, Illinois |
| Authorized Official Name and Position | Dale Charles Nickelsen (PRESIDENT) |
| Authorized Official Contact | 8476951693 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry Ltd 860 Summit St Suite 246 Elgin IL 60120-5145 Ph: (847) 695-1693 | Pediatric Dentistry Ltd 860 Summit St Suite 246 Elgin IL 60120-5145 Ph: (847) 695-1693 |
| NPI Number | 1952454878 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952454878 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Illinois) | Primary |
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