MODERN DENTAL OF ROCKFORD LLC NPI 1346563525

NPI Information

NPI: 1346563525
Provider Name: MODERN DENTAL OF ROCKFORD LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1321 SANDY HOLLOW RD
ROCKFORD, IL
ZIP 61109
Phone: (815) 209-9070
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MODERN DENTAL OF ROCKFORD LLC is a general practice dentist in Rockford, IL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. MODERN DENTAL OF ROCKFORD LLC NPI is 1346563525. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1321 SANDY HOLLOW RD
ROCKFORD, IL
ZIP 61109-120
Phone: (815) 209-9070

The provider's authorized official is Jeff Thomas .
The authorized official title is President and has the following contact phone number (618) 532-4902.

The enumeration date for this NPI number is 3/2/2010 and was last updated on 3/2/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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