Southern Illinois Oral & Maxillofacial Surgery, Ltd.
NPI #1538180617 in Belleville, Illinois
Provider Information
- NPI Number
- 1538180617
- Entity Type
- Organization
- Organization Name
- Southern Illinois Oral & Maxillofacial Surgery, Ltd.
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Jul 22, 2006
- Last Updated
- Nov 24, 2014
Practice Location
- Address
- 2900 FRANK SCOTT PKWY W
- Address 2
- SUITE 960
- City
- Belleville
- State
- Illinois
- ZIP Code
- 62223-5000
- Phone
- (618) 233-8080
Authorized Official
- Name
- DR. MICHAEL R. HESTERBERG, D.M.D.
- Title
- PRESIDENT
- Phone
- (618) 233-8080
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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