| Rockford Family Dental P.c. | |
|
2715 N Main St Rockford IL 61103-3111 | |
| (815) 964-8713 | |
| (815) 964-3719 |
| Full Name | Rockford Family Dental P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2715 N Main St, Rockford, Illinois |
| Authorized Official Name and Position | Razvan Cornel Mirza (SECRETARY/TREASURER) |
| Authorized Official Contact | 8159648713 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rockford Family Dental P.c. 2715 N Main St Rockford IL 61103-3111 Ph: (815) 964-8713 | Rockford Family Dental P.c. 2715 N Main St Rockford IL 61103-3111 Ph: (815) 964-8713 |
| NPI Number | 1386982940 |
|---|---|
| Provider Enumeration Date | 01/16/2013 |
| Last Update Date | 05/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386982940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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