ROCKFORD MODERN DENTAL LLC

ROCKFORD, IL
NPI1316260599
Entity TypeOrganization
Authorized ContactJEFF THOMAS
President
618-532-4902
Organization Subpart ?No
Primary Taxonomy1223G0001X Dentist, General Practice
Enumeration Date2010-03-02
Last Update Date2010-03-02
Business Address
ROCKFORD MODERN DENTAL LLC
5909 E STATE ST
ROCKFORD, IL 61108-2429
Phone number: 815-904-8701
Mailing Address
ROCKFORD MODERN DENTAL LLC
5909 E STATE ST
ROCKFORD, IL 61108-2429
Phone number: 815-904-8701
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