Midwest Family Dentistry PC

NPI #1558484410 in Granite City, Illinois

Provider Information

NPI Number: 1558484410
Entity Type: Organization
Organization Name: Midwest Family Dentistry PC
Primary Specialty: Dentist
Enumeration Date: Apr 7, 2007
Last Updated: Aug 11, 2015

Practice Location

Address: 3120 MARYVILLE RD
City: Granite City
State: Illinois
ZIP Code: 62040-5119
Phone: (618) 797-9940

Authorized Official

Name: DR. LANEY ELAYNE SCHUMAN-BOYS, DMD
Title: PRESIDENT
Phone: (618) 797-9940

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment	332BC3200X
Dentist	122300000X	Primary

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