Spring Valley Dental Associates LLC

NPI #1154040830 in O Fallon, Illinois

Provider Information

NPI Number: 1154040830
Entity Type: Organization
Organization Name: Spring Valley Dental Associates LLC
Primary Specialty: Dentist
Enumeration Date: Aug 25, 2022
Last Updated: Aug 25, 2022

Practice Location

Address: 904 E HIGHWAY 50
City: O Fallon
State: Illinois
ZIP Code: 62269-2868
Phone: (186) 632-8471

Authorized Official

Name: DIANA LIFRITZ
Title: OPERATIONS MANAGER OF CREDENTIALING
Phone: (636) 578-5027

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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