| Total Health Dentistry | |
|
615 35th Avenue Moline IL 61265 | |
| (309) 762-3015 | |
| (309) 762-1461 |
| Full Name | Total Health Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 615 35th Avenue, Moline, Illinois |
| Authorized Official Name and Position | Jacquelyn Leah Richardson (PRESIDENT DENTIST) |
| Authorized Official Contact | 3097623015 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Health Dentistry 615 35th Avenue Moline IL 61265 Ph: (309) 762-3015 | Total Health Dentistry 615 35th Avenue Moline IL 61265 Ph: (309) 762-3015 |
| NPI Number | 1649305921 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 06/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649305921 | NPI | - | NPPES |
| 110282 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019026572 (Illinois) | Primary |
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