Jill Kinsella Dmd LLC

NPI #1043589526 in Scott Afb, Illinois

Provider Information

NPI Number: 1043589526
Entity Type: Organization
Organization Name: Jill Kinsella Dmd LLC
Primary Specialty: Dentist
Enumeration Date: Dec 29, 2011
Last Updated: Jun 21, 2018

Practice Location

Address: 703 SEIBERT RD.
Address 2: SUITE 5
City: Scott Afb
State: Illinois
ZIP Code: 62225
Phone: (618) 744-1969

Authorized Official

Name: JILL ANNE KINSELLA, DMD
Title: OWNER/DENTIST
Phone: (618) 744-1969

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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