Green Mount Dental, LLC
NPI #1306212170 in Belleville, Illinois
Provider Information
- NPI Number
- 1306212170
- Entity Type
- Organization
- Organization Name
- Green Mount Dental, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 17, 2015
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 2810 FRANK SCOTT PKWY W STE 800
- City
- Belleville
- State
- Illinois
- ZIP Code
- 62223-5007
- Phone
- (618) 235-9696
Authorized Official
- Name
- DAVID GUILBEAULT
- Title
- OWNER/DENTIST
- Phone
- (618) 643-9523
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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