Jerseyville Dental Group LLC

NPI #1386414290 in Jerseyville, Illinois

Provider Information

NPI Number
1386414290
Entity Type
Organization
Organization Name
Jerseyville Dental Group LLC
Primary Specialty
Dentist
Enumeration Date
Jan 3, 2024
Last Updated
Jan 3, 2024

Practice Location

Address
105 S STATE ST
ZIP Code
62052-1850
Phone
(618) 498-5822

Authorized Official

Name
DIANA LIFRITZ
Title
DIRECTOR OF OPERATIONS/ACQUISITIONS
Phone
(618) 873-7500

Specialties & Taxonomy Codes

Specialty
Dentist

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Provider Name
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Organizations

Provider Name
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