Unknown Individual – General Practice Dentistry, NPI 1104809177
General Practice Dentistry
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
West State Street, Rockford, Winnebago County, Illinois, 61102, United States
ROCKFORD, IL 611022112
Phone: (815) 490-1600
Type: Location
1312, Creekwood Circle, Forest Vale Estates, Rockford, Rockford Township, Winnebago County, Illinois, 61108, United States
ROCKFORD, IL 611081531
Phone: (815) 398-0596
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61102)
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