Dental Professionals of Illinois, P.c.
NPI #1093937336 in Glen Carbon, Illinois
Provider Information
- NPI Number
- 1093937336
- Entity Type
- Organization
- Organization Name
- Dental Professionals of Illinois, P.c.
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- DENTAL PROFESSIONALS OF ILLINOIS, P.C.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 3, 2007
- Last Updated
- Oct 31, 2024
Practice Location
- Address
- 87 MAGNOLIA DR
- City
- Glen Carbon
- State
- Illinois
- ZIP Code
- 62025-1535
- Phone
- (618) 692-9980
Authorized Official
- Name
- ERIKA DAVIS
- Title
- CREDENTIALING COORDINATOR
- Phone
- (217) 540-8434
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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