| Perryville Dentist Pc | |
|
845 S Perryville Rd Unit 119 Rockford IL 61108 | |
| (847) 354-0127 | |
| Not Available |
| Full Name | Perryville Dentist Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 845 S Perryville Rd, Rockford, Illinois |
| Authorized Official Name and Position | Jabal R Patel (OWNER) |
| Authorized Official Contact | 8473540127 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Perryville Dentist Pc 845 S Perryville Rd Unit 119 Rockford IL 61108 Ph: (847) 354-0127 | Perryville Dentist Pc 845 S Perryville Rd Unit 119 Rockford IL 61108 Ph: (847) 354-0127 |
| NPI Number | 1730547936 |
|---|---|
| Provider Enumeration Date | 02/02/2016 |
| Last Update Date | 02/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730547936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019.026938 (Illinois) | Primary |
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