Access Dental of Normal PLLC

Organization Active NPI General Practice Dentistry · Normal, IL

NPI 1205595915 · NPPES record last updated Dec 9, 2021

Key facts

NPI
1205595915
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
ACCESS DENTAL OF NORMAL PLLC
Practice address
305 S Linden St Ste 101
Normal, IL 61761-4906
Phone
(309) 296-0227
NPI assigned
Dec 9, 2021
Organization subpart
No

Authorized official

Name
Andrea Carrillo
Title
Regional Director
Phone
(512) 351-2612

National Provider Directory

Locations

305 S Linden St
Ste 101
Normal, IL 61761
Phone (309) 296-0227

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

305 S Linden St Ste 101
Normal, IL 61761-4906

Mailing address

305 S Linden St Ste 101
Normal, IL 61761-4906

Other providers in Normal, IL

All providers in Normal, IL · General Practice Dentistry in Illinois

Sources for this page

Verify at the official NPI Registry.