Provider Demographics
NPI:1316029044
Name:ASSOCIATES IN DENTISTRY
Entity Type:Organization
Organization Name:ASSOCIATES IN DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-697-5680
Mailing Address - Street 1:1518 W GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BARTONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61607-1755
Mailing Address - Country:US
Mailing Address - Phone:309-697-5680
Mailing Address - Fax:309-697-5682
Practice Address - Street 1:336 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:IL
Practice Address - Zip Code:61520-1826
Practice Address - Country:US
Practice Address - Phone:309-647-3331
Practice Address - Fax:309-649-5439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty