Organization · Type 2 NPI

Familia Dental Moline LLC

Dental Clinic/Center · Moline, IL

NPI number 1588084479 Active

Practice location

1102 4th Ave.
Moline, IL 61265-1231

Call (309) 517-6217 Map

Fax (309) 517-6219

Mailing address

2050 East Algonquin Road, Suite 610
Schaumburg, IL 60173-4166

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry	1223G0001X	None listed
Dental Clinic/Center Primary	261QD0000X	None listed

Dental Clinic/Center: Definition to come...

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NPI record

NPI: 1588084479
Entity type: Organization (Type 2)
Issued: Apr 18, 2014
Last updated: Jun 25, 2021
Status: Active

Other names

<unavail>
Familia Dental · doing business as
Familia Dental · doing business as

Authorized official

Mr. Brandon Alexander Taylor, CPCS
Credentialing & Payer Relations Man
(847) 453-7396

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1588084479

Familia Dental Moline LLC's National Provider Identifier is 1588084479, issued on Apr 18, 2014. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Moline, IL. The record was last updated on Jun 25, 2021.