Riverside Dental Investments Llc | |
13510 Julie Dr Poplar Grove IL 61065-7829 | |
(815) 765-9900 | |
(815) 765-9901 |
Full Name | Riverside Dental Investments Llc |
---|---|
Speciality | Clinic/center |
Location | 13510 Julie Dr, Poplar Grove, Illinois |
Authorized Official Name and Position | Sara J Bailey (OFFICE MANAGER) |
Authorized Official Contact | 8157659900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Riverside Dental Investments Llc 13510 Julie Dr Poplar Grove IL 61065-7829 Ph: (815) 765-9900 | Riverside Dental Investments Llc 13510 Julie Dr Poplar Grove IL 61065-7829 Ph: (815) 765-9900 |
NPI Number | 1386217164 |
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Provider Enumeration Date | 07/20/2021 |
Last Update Date | 07/20/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386217164 | NPI | - | NPPES |
1134353014 | Other | IL | INDIVIDUAL NPI |
1356461255 | Other | IL | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |