OrganizationActive
Maple Shade Dental (dunlap) LLC
NPI 1134416795 · Dentist · Dunlap, IL
Provider details
- NPI number
- 1134416795
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Mike Cole, Insurance Director(727) 726-1611
Specialties & taxonomies
Dental Providers
Practice location
11825 State Route 40
Suite 200
Dunlap, IL 61525-8842
Phone: (309) 243-7702
Fax: (309) 243-9061
Approximate (ZIP-level) locationGet directions
Mailing address
6240 Lake Osprey Dr Dept 56058
Lakewood Ranch, FL 34240-8421
Registry dates
- Enumerated
- 2011-07-05
- Last updated
- 2024-03-18
- Certified
- 2024-03-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.