| Putman Dental Inc | |
|
927 S Durkin Dr Ste A Springfield IL 62704-6017 | |
| (217) 793-0070 | |
| Not Available |
| Full Name | Putman Dental Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 927 S Durkin Dr Ste A, Springfield, Illinois |
| Authorized Official Name and Position | William Putman (OWNER/GENERAL DENTIST) |
| Authorized Official Contact | 2176520378 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Putman Dental Inc 832 Coventry Pt Springfield IL 62702-3389 Ph: (217) 652-0378 | Putman Dental Inc 927 S Durkin Dr Ste A Springfield IL 62704-6017 Ph: (217) 793-0070 |
| NPI Number | 1760134563 |
|---|---|
| Provider Enumeration Date | 01/22/2022 |
| Last Update Date | 03/28/2022 |
| Medicare PECOS PAC ID | 4587050182 |
|---|---|
| Medicare Enrollment ID | O20220407001589 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760134563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | William H Putman |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1225542913 PECOS PAC ID: 8729474325 Enrollment ID: I20220407001729 |
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