MAPLE SHADE DENTAL BLOOMINGTON LLC

BLOOMINGTON, IL
NPI1366795437
Entity TypeOrganization
Authorized ContactMIKE COLE
VP Insurance Plan Management
727-726-1611
Organization Subpart ?No
Primary Taxonomy122300000X Dentist
Enumeration Date2012-10-26
Last Update Date2015-04-23
Business Address
MAPLE SHADE DENTAL BLOOMINGTON LLC
107 S PROSPECT RD
BLOOMINGTON, IL 61704-4403
Phone number: 309-663-0433
Mailing Address
MAPLE SHADE DENTAL BLOOMINGTON LLC
107 S PROSPECT RD
BLOOMINGTON, IL 61704-4403
Phone number:
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