Provider Demographics
NPI:1871651554
Name:DR RICHARD P JUNE DDS PC
Entity Type:Organization
Organization Name:DR RICHARD P JUNE DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:JUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-364-3981
Mailing Address - Street 1:309 EDWARD ST
Mailing Address - Street 2:
Mailing Address - City:HENRY
Mailing Address - State:IL
Mailing Address - Zip Code:61537-1501
Mailing Address - Country:US
Mailing Address - Phone:309-364-3981
Mailing Address - Fax:309-364-3984
Practice Address - Street 1:309 EDWARD ST
Practice Address - Street 2:
Practice Address - City:HENRY
Practice Address - State:IL
Practice Address - Zip Code:61537-1501
Practice Address - Country:US
Practice Address - Phone:309-364-3981
Practice Address - Fax:309-364-3984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A151321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty