Unknown Individual – Dentist, NPI 1174689897
Dentist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
3100, North Dries Lane, Sunset Hills, El Vista, Peoria, Peoria County, Illinois, 61604, United States
SUITE 301
PEORIA, IL 61604
Phone: (309) 688-6646
Fax: (309) 688-6645
Mailing address matches the actual address.
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 61604)
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