| Northgate Family Dental | |
|
3412 W Willow Knolls Road Suite A Peoria IL 61614 | |
| (309) 690-3262 | |
| (309) 693-8295 |
| Full Name | Northgate Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3412 W Willow Knolls Road, Peoria, Illinois |
| Authorized Official Name and Position | Lindsay Bearden (INS COOD) |
| Authorized Official Contact | 2175405100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northgate Family Dental 3412 W Willow Knolls Road Suite A Peoria IL 61614 Ph: (309) 690-3262 | Northgate Family Dental 3412 W Willow Knolls Road Suite A Peoria IL 61614 Ph: (309) 690-3262 |
| NPI Number | 1376765818 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 01/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376765818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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› Verified 3 days ago
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