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1780256503
KANKAKEE DENTAL PLLC
KANKAKEE, IL
NPI
1780256503
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Entity Type
Organization
Authorized Contact
KEVIN FATLAND
Member
708-990-7869
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2021-07-12
Last Update Date
2021-07-12
Business Address
KANKAKEE DENTAL PLLC
200 E COURT ST STE 504
KANKAKEE, IL 60901-3847
Phone number: 815-932-3613
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Mailing Address
KANKAKEE DENTAL PLLC
200 E COURT ST STE 504
KANKAKEE, IL 60901-3847
Phone number: 815-932-3613
Copy
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