| Prairie Dental Partners Llc | |
|
4746 Main St Lisle IL 60532-1724 | |
| (630) 968-5078 | |
| Not Available |
| Full Name | Prairie Dental Partners Llc |
|---|---|
| Speciality | Dentist |
| Location | 4746 Main St, Lisle, Illinois |
| Authorized Official Name and Position | Oscar G Gonzalez (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 2194658627 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Dental Partners Llc 4746 Main St Lisle IL 60532-1724 Ph: (630) 968-5078 | Prairie Dental Partners Llc 4746 Main St Lisle IL 60532-1724 Ph: (630) 968-5078 |
| NPI Number | 1669935193 |
|---|---|
| Provider Enumeration Date | 04/11/2019 |
| Last Update Date | 04/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669935193 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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