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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

NPI # 1154607422
LBN Legal business name SECURE DENTAL LLC
Authorized official NOEL LIU - (MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/31/2011
Last updated 01/27/2012 - About 14 years ago
Identifiers
IL License # 019027468
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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