Illinois Valley Endodontics Llc in Peru - Endodontics
Illinois Valley Endodontics Llc - NPI 1407031305
Illinois Valley Endodontics Llc is a Endodontics in Peru, Illinois. Illinois Valley Endodontics Llc practices all healthcare services and medical treatments related to Endodontics. The NPI Number for Illinois Valley Endodontics Llc is 1407031305. The last update date is 2008-01-09.
Illinois Valley Endodontics Llc's current location address is 1601 4th St, Peru, Illinois. You can contact this provider via phone number 8152243636 and fax number 8152201479. The mailing address for Illinois Valley Endodontics Llc is 1601 4th St, Peru, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Illinois Valley Endodontics Llc |
|---|---|
| Address | 1601 4th St, Peru, Illinois |
| Phone Number | 8152243636 |
| Fax Number | 8152201479 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/DENT |
|---|---|
| Authorized Official Name | Ceresa Michael Lee |
| Credentials | DDS |
| Telephone Number | 8152243636 |
NPI Number Detail
| NPI Number | 1407031305 |
|---|---|
| Provider Enumeration Date | 2008-01-09 |
| Last Updated Date | 2008-01-09 |
Provider Mailing Address Detail
| Address | 1601 4th St |
|---|---|
| City | Peru |
| State | Illinois (IL) |
| Post Code | 613543507 |
| Phone Number | 8152243636 |
| Fax Number | 8152201479 |
Provider's Primary Taxonomy Detail
| Speciality | Endodontics |
|---|---|
| Taxonomy | 1223E0200X |
|
Definition: The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the eti |
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What is the unique 10-digit identifier code assigned to Illinois Valley Endodontics Llc by the Centers for Medicare & Medicaid Services?
The Illinois Valley Endodontics Llc has been issued the NPI (National Provider Identifier) 1407031305 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Illinois Valley Endodontics Llc's facilities are situated?
The facilities of Illinois Valley Endodontics Llc are physically located at the following address: 1601 4Th St, Peru, IL, 613543507.
What is Illinois Valley Endodontics Llc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Illinois Valley Endodontics Llc's area of specialization is Endodontics, and the corresponding taxonomy code that categorizes this field of practice is 1223E0200X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1407031305 to Illinois Valley Endodontics Llc?
The Centers for Medicare & Medicaid Services originally issued the 1407031305 to Illinois Valley Endodontics Llc on 2008-01-09.
As of what date were the details pertaining to Illinois Valley Endodontics Llc last refreshed?
The information related to the Illinois Valley Endodontics Llc, including its address, specialty, and other relevant details, was last updated on 2008-01-09.