| Shady Oak Dental Llc - Burlington Dental | |
|
255 S Main St Burlington IL 60109-1116 | |
| (847) 683-9812 | |
| Not Available |
| Full Name | Shady Oak Dental Llc - Burlington Dental |
|---|---|
| Speciality | Dentist |
| Location | 255 S Main St, Burlington, Illinois |
| Authorized Official Name and Position | Scott C Bares (PRESIDENT) |
| Authorized Official Contact | 8159382575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shady Oak Dental Llc - Burlington Dental 255 S Main St Burlington IL 60109-1116 Ph: (847) 683-9812 | Shady Oak Dental Llc - Burlington Dental 255 S Main St Burlington IL 60109-1116 Ph: (847) 683-9812 |
| NPI Number | 1396351425 |
|---|---|
| Provider Enumeration Date | 09/23/2020 |
| Last Update Date | 09/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396351425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
Burlington Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 255 S. Main St, Burlington, IL 60109 Phone: 847-683-9812 Fax: 847-683-9801 |