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1477148179
SMALLTOWN DENTAL GLEN LLC
PEORIA, IL
NPI
1477148179
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Entity Type
Organization
Authorized Contact
LUKE OVERCASH
Operations Manager
309-370-5853
Organization Subpart ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
Enumeration Date
2021-03-04
Last Update Date
2021-03-04
Business Address
SMALLTOWN DENTAL GLEN LLC
2015 W GLEN AVE STE 230
PEORIA, IL 61614-4691
Phone number: 309-673-4616
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Mailing Address
SMALLTOWN DENTAL GLEN LLC
1600 S 4TH AVE STE 110
MORTON, IL 61550-3401
Phone number: 309-370-5853
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