Milestone Dental Clinic

LBN: Milestone Dental Clinic
Milestone Dental Clinic is an health care organization with primary practice located at 275 North Phelps Avenue , Rockford IL 61108-2434. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Milestone Dental Clinic can be contacted via phone (815) 484-8678, or through Hamilton, James P via phone (815) 636-2801.

Contact Information

Primary practice address
275 North Phelps Avenue Rockford IL 61108-2434
Phone: (815) 484-8678
Fax: (815) 484-8680
Website:
Map and Directions
Authorized official contact:
Name: Hamilton, James P
Phone: (815) 636-2801

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1841461845
LBN Legal business name Milestone Dental Clinic
DBA Doing business as
Authorized official Hamilton, James P
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 18th, 2008
Last updated Mar 18th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841461845 NPPES
Illinois MEDICAID 102303

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