Lincoln Place Dental PC
NPI #1417221532 in Belleville, Illinois
Provider Information
- NPI Number
- 1417221532
- Entity Type
- Organization
- Organization Name
- Lincoln Place Dental PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Mar 7, 2012
- Last Updated
- Mar 7, 2012
Practice Location
- Address
- 114 LINCOLN PLACE CT
- City
- Belleville
- State
- Illinois
- ZIP Code
- 62221-5884
- Phone
- (618) 257-9189
Authorized Official
- Name
- DR. GERALD WAYNE DORTCH, DMD
- Title
- OWNER
- Phone
- (618) 257-9189
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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