Alpha Dental Care
Organization Active NPI Dentist · Peru, IL
NPI 1386981371 · NPPES record last updated Jan 10, 2013
Key facts
- NPI
- 1386981371
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 019-022454 (IL)
- Legal business name
- ALPHA DENTAL CARE
- Practice address
- 4105 Frontage Rd
Peru, IL 61354-1115 - Phone
- (815) 223-5839
- Fax
- (815) 223-0957
- NPI assigned
- Jan 10, 2013
- Organization subpart
- No
Authorized official
- Name
- Kim Ann Goss
- Title
- Business Receptionist
- Phone
- (815) 223-5839
Practitioners 1
-
Daniel T Moran, D.D.S.
National Provider Directory
Locations
4105 Frontage Rd
Peru, IL 61354
Phone (815) 223-5839
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 019-022454 | IL | Yes |
Addresses
Primary practice location
4105 Frontage Rd
Peru, IL 61354-1115
Mailing address
4105 Frontage Rd
Peru, IL 61354-1115
Phone (815) 223-5839
Other providers in Peru, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.