Organization · Type 2 NPI

Dental Professionals of Illinois, P.c.

General Practice Dentistry · Beardstown, IL

NPI number 1629471016 Active

Practice location

507 Washington St
Beardstown, IL 62618-1558

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

5 other providers at this address

NPI record

NPI: 1629471016
Entity type: Organization (Type 2)
Issued: Sep 30, 2014
Last updated: Sep 30, 2014
Status: Active
Subpart: Yes of Dental Professionals of Illinois, P.c.

Other names

<unavail>
Beardstown Family Dental · doing business as

Authorized official

Kim Wilson
Cred Supervisor
(217) 540-5170

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.

Is this your record? How to update it.

About NPI 1629471016

Dental Professionals of Illinois, P.c.'s National Provider Identifier is 1629471016, issued on Sep 30, 2014. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Beardstown, IL. The record was last updated on Sep 30, 2014.