| Smalltown Dental Willow Knolls Llc | |
|
6712 N Mountello Dr Peoria IL 61614-2328 | |
| (309) 691-7855 | |
| Not Available |
| Full Name | Smalltown Dental Willow Knolls Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6712 N Mountello Dr, Peoria, Illinois |
| Authorized Official Name and Position | Luke Overcash (OPERATIONS MANAGER) |
| Authorized Official Contact | 3093705853 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smalltown Dental Willow Knolls Llc 6712 N Mountello Dr Peoria IL 61614-2328 Ph: (309) 691-7855 | Smalltown Dental Willow Knolls Llc 6712 N Mountello Dr Peoria IL 61614-2328 Ph: (309) 691-7855 |
| NPI Number | 1699365809 |
|---|---|
| Provider Enumeration Date | 01/21/2021 |
| Last Update Date | 01/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699365809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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Thomas C. Ferlmann Dmd , Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4325 N Sheridan Rd, Peoria, IL 61614 Phone: 309-685-0032 | |
Laura J Donlan Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7314 N Willowlake Court, Suite D, Peoria, IL 61614 Phone: 309-692-0175 Fax: 309-692-3139 | |
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Richard T. Moon, D.d.s., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6712 N Mountello Dr, Peoria, IL 61614 Phone: 309-691-7855 Fax: 309-691-8853 | |
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