| Pine Glen Dental Group, Ltd | |
|
838 W Glen Ave Peoria IL 61614-4835 | |
| (309) 691-1990 | |
| (309) 691-9112 |
| Full Name | Pine Glen Dental Group, Ltd |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 838 W Glen Ave, Peoria, Illinois |
| Authorized Official Name and Position | Robert Michael Pollard (PRESIDENT) |
| Authorized Official Contact | 3096911990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Glen Dental Group, Ltd 838 W Glen Ave Peoria IL 61614-4835 Ph: (309) 691-1990 | Pine Glen Dental Group, Ltd 838 W Glen Ave Peoria IL 61614-4835 Ph: (309) 691-1990 |
| NPI Number | 1659589299 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659589299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |
Pine Glen Dental Group, Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 838 W Glen Ave, Peoria, IL 61614 Phone: 309-691-1990 Fax: 309-691-9112 | |
Thomas C. Ferlmann Dmd , Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4325 N Sheridan Rd, Peoria, IL 61614 Phone: 309-685-0032 | |
Laura J Donlan Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7314 N Willowlake Court, Suite D, Peoria, IL 61614 Phone: 309-692-0175 Fax: 309-692-3139 | |
Smile Design Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7310 N. Villa Lake Drive, Suite A, Peoria, IL 61614 Phone: 309-689-0746 Fax: 309-689-0759 | |
Richard T. Moon, D.d.s., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6712 N Mountello Dr, Peoria, IL 61614 Phone: 309-691-7855 Fax: 309-691-8853 | |
Martin Ruelas, Dmd, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10330 N Juliet Ct, Peoria, IL 61615 Phone: 309-243-8455 Fax: 309-243-8466 | |
Associated Oral Surgeons Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5720 N Knoxville Ave, Peoria, IL 61614 Phone: 309-682-1213 Fax: 309-682-5386 |