| Port Byron Family Dentistry | |
|
308 11th St Port Byron IL 61275-9038 | |
| (309) 523-3325 | |
| Not Available |
| Full Name | Port Byron Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 308 11th St, Port Byron, Illinois |
| Authorized Official Name and Position | Scott Bialobreski (PRESIDENT) |
| Authorized Official Contact | 3099322000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Byron Family Dentistry 308 11th St Port Byron IL 61275-9038 Ph: (309) 523-3325 | Port Byron Family Dentistry 308 11th St Port Byron IL 61275-9038 Ph: (309) 523-3325 |
| NPI Number | 1518330505 |
|---|---|
| Provider Enumeration Date | 11/12/2015 |
| Last Update Date | 11/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518330505 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019030515 (Illinois) | Primary |
Gregory L Glade Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 11th St North, Port Byron, IL 61275 Phone: 309-523-3325 Fax: 309-523-9078 |