Spring Grove Dental | |
2450 N Us Highway 12 Unit E Spring Grove IL 60081-8361 | |
(815) 675-1156 | |
Not Available |
Full Name | Spring Grove Dental |
---|---|
Speciality | Dentist |
Location | 2450 N Us Highway 12, Spring Grove, Illinois |
Authorized Official Name and Position | Brian Rybicki (PRESIDENT) |
Authorized Official Contact | 8156751156 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Spring Grove Dental 2450 N Us Highway 12 Po Box 310 Spring Grove IL 60081-8361 Ph: (815) 675-1156 | Spring Grove Dental 2450 N Us Highway 12 Unit E Spring Grove IL 60081-8361 Ph: (815) 675-1156 |
NPI Number | 1477710192 |
---|---|
Provider Enumeration Date | 05/20/2008 |
Last Update Date | 05/20/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477710192 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 019-026190 (Illinois) | Primary |