| Jonathan Phen, | |
|
502 Riverside Dr, East Peoria, IL 61611-2068 | |
| (309) 606-5008 | |
| Not Available |
| Full Name | Jonathan Phen |
|---|---|
| Gender | Male |
| Speciality | Dentist |
| Location | 502 Riverside Dr, East Peoria, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093400160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019034133 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan Phen, 2121 45th St Apt 2322, Highland, IN 46322-0006 Ph: (954) 997-4175 | Jonathan Phen, 502 Riverside Dr, East Peoria, IL 61611-2068 Ph: (309) 606-5008 |
Dr. Melissa Ann Porter, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 134 Mckinley St, East Peoria, IL 61611 Phone: 309-699-6770 | |
Dr. David Ralph Trost, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 134 Mckinley St, East Peoria, IL 61611 Phone: 309-699-6770 Fax: 309-699-6771 | |
Dr. Michael Norman Gabor, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 133 Oakmoor Dr., East Peoria, IL 61611 Phone: 309-698-9201 | |
Dr. Seo Woo Choi, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 502 Riverside Dr, East Peoria, IL 61611 Phone: 309-606-5008 | |
Dr. Morgan Marie Shanahan, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 809 W Camp St, East Peoria, IL 61611 Phone: 309-694-0606 | |
Taylor Pham, Dentist Medicare: Not Enrolled in Medicare Practice Location: 368 W Washington St, East Peoria, IL 61611 Phone: 309-694-4444 |