CENTRAL ILLINOIS ORAL AND MAXIOFACIAL SURGERY, PC

CHAMPAIGN, IL
NPI1851540330
Entity TypeOrganization
Authorized ContactPAM HARDIEK
Insurance/Credentialing
217-540-5100
Organization Subpart ?Yes
Primary Taxonomy1223G0001X Dentist General Practice
Enumeration Date2008-09-09
Last Update Date2008-09-11
Business Address
CENTRAL ILLINOIS ORAL AND MAXIOFACIAL SURGERY, PC
14 E ANTHONY DR STE C
CHAMPAIGN, IL 61820-2749
Phone number: 217-355-2809
Mailing Address
CENTRAL ILLINOIS ORAL AND MAXIOFACIAL SURGERY, PC
14 E ANTHONY DR STE C
CHAMPAIGN, IL 61820-2749
Phone number: 217-355-2809
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