| Noll Dental Clinic | |
|
5220 6th Street Frontage Rd E Ste 2400 Springfield IL 62703-5761 | |
| (217) 788-2300 | |
| (217) 788-2340 |
| Full Name | Noll Dental Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 5220 6th Street Frontage Rd E Ste 2400, Springfield, Illinois |
| Authorized Official Name and Position | Jason Jones (CFO) |
| Authorized Official Contact | 2177882300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Noll Dental Clinic 2239 E Cook St Springfield IL 62703-1944 Ph: (217) 788-2300 | Noll Dental Clinic 5220 6th Street Frontage Rd E Ste 2400 Springfield IL 62703-5761 Ph: (217) 788-2300 |
| NPI Number | 1861911893 |
|---|---|
| Provider Enumeration Date | 09/11/2017 |
| Last Update Date | 09/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861911893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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