Lewis and Clark Community College

NPI #1497746077 in Godfrey, Illinois

Provider Information

NPI Number
1497746077
Entity Type
Organization
Organization Name
Lewis and Clark Community College
Primary Specialty
Dentist
Enumeration Date
Nov 2, 2005
Last Updated
Aug 22, 2020

Practice Location

Address
5800 GODFREY RD
ZIP Code
62035-2466
Phone
(618) 468-4463

Authorized Official

Name
DR. JOHN RANDALL MILLER, D.D.S.
Title
CLINIC SUPERVISOR
Phone
(618) 468-4414

Specialties & Taxonomy Codes

Specialty
Dentist

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