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Contact Information

SECURE DENTAL LLC
3127 N. UNIVERSITY ST.
PEORIA, IL61604
 Phone: 309-681-8888
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for SECURE DENTAL LLC · (Female)

NPI # 1154607422
Status Active
Credentials
Entity Individual
Enumeration date 10/31/2011
Last updated 01/27/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL License # 019027468
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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