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KRALLYODER PC NPI 1891957726


NPI Information

NPI: 1891957726
Provider Name: KRALLYODER PC

Doing Business As: METAMORA FAMILY DENTAL

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
212 N DAVENPORT ST
METAMORA, IL
ZIP 61548
Phone: (309) 369-2378
Get Directions

KRALLYODER PC is a general practice dentist in Metamora, IL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. KRALLYODER PC NPI is 1891957726. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Metamora Family Dental.

The provider's business location address is:

212 N DAVENPORT ST
METAMORA, IL
ZIP 61548-395
Phone: (309) 369-2378

The provider's authorized official is Kyle Andrew Krall .
The authorized official title is President and has the following contact phone number (309) 367-2378.

The enumeration date for this NPI number is 7/1/2008 and was last updated on 5/4/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice019018768ILLINOISNo
2261QD0000XClinic/CenterDentalNo
31223G0001XDentistGeneral Practice019025832ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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