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Dr. Kenneth Lee Myracle, DMD
General Practice Dentistry in Mattoon, Illinois
NPI 1588862254

Kenneth Lee Myracle is a General Practice Dentistry based in Mattoon, IL and is specialized in General Practice. Kenneth Lee Myracle practices in Mattoon, IL and has the professional credentials of DMD. The NPI Number for Kenneth Lee Myracle is 1588862254 and holds a License No. (Illinois).

The current practice location address for Kenneth Lee Myracle is 700 Broadway Ave E, Mattoon, IL and can be reached out via phone at 217-235-1101. You can also correspond with Kenneth Lee Myracle through the mailing address at 13 S COUNTRY CLUB RD, MATTOON, IL - 61938-9023 (mailing address contact number: 217-258-8781).

Location: 700 Broadway Ave E, Mattoon, IL, 61938-9023
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1588862254
Provider Name
Kenneth Lee Myracle
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
700 Broadway Ave E, Mattoon, IL, 61938-9023
Phone Number
217-235-1101
Fax Number
Provider Enumeration Date
07/04/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
700 Broadway Ave E
City
Mattoon
State
Illinois
Zip
61938-4671
Phone Number
217-235-1101
Fax Number
person
Provider Business Mailing Address Details
Address
13 S Country Club Rd
City
Mattoon
State
Illinois
Zip
61938-9023
Phone Number
217-258-8781
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
(Illinois)
Definition
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.
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