| William E. Cusack, D.d.s., Ltd. | |
|
5013 N University St Ste 2 Peoria IL 61614-4796 | |
| (309) 693-2220 | |
| (309) 693-2272 |
| Full Name | William E. Cusack, D.d.s., Ltd. |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 5013 N University St Ste 2, Peoria, Illinois |
| Authorized Official Name and Position | Kimberly Sue Cusack (PRESIDENT) |
| Authorized Official Contact | 3093608592 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| William E. Cusack, D.d.s., Ltd. 5013 N University St Ste 2 Peoria IL 61614-4796 Ph: (309) 693-2220 | William E. Cusack, D.d.s., Ltd. 5013 N University St Ste 2 Peoria IL 61614-4796 Ph: (309) 693-2220 |
| NPI Number | 1346060217 |
|---|---|
| Provider Enumeration Date | 10/15/2024 |
| Last Update Date | 10/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346060217 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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