Freeport Family Dental, LLC
Dentist, General Practice in Freeport, IL. Organization (NPI-2).
NPI number1013667534
StatusActive
Last updated in NPPESMar 27, 2022
Details
- NPI
- 1013667534
- Entity type
- Organization (NPI-2)
- Legal business name
- Freeport Family Dental, LLC
- Organization subpart
- No
- Enumeration date
- Mar 27, 2022
- Certification date
- Mar 27, 2022
- Last updated
- Mar 27, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
981 W South StFreeport, IL 61032-6778
Phone 815-235-5174
Mailing address
981 W South StFreeport, IL 61032-6778
Authorized official
Mahmoud Salameh
Manager
7085430089
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