Peoria Dental Care

LBN: Peoria Dental Care
Peoria Dental Care is an health care organization with primary practice located at 4517 N Rockwood Dr , Peoria IL 61615-3841. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. Peoria Dental Care can be contacted via phone (309) 688-0121, or through Wynn, Robert via phone (309) 688-0121.

Contact Information

Primary practice address
4517 N Rockwood Dr Peoria IL 61615-3841
Phone: (309) 688-0121
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wynn, Robert Doctor of Dental Surgery (DDS)
Phone: (309) 688-0121

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X

Profile Details

NPI number 1851909345
LBN Legal business name Peoria Dental Care
DBA Doing business as
Authorized official Wynn, Robert Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 21st, 2020
Last updated Jul 21st, 2020 - about 5 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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