Southern Illinois Pediatric Dentistry of Edwardsville
NPI #1568925014 in Edwardsville, Illinois
Provider Information
- NPI Number
- 1568925014
- Entity Type
- Organization
- Organization Name
- Southern Illinois Pediatric Dentistry of Edwardsville
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Apr 11, 2019
- Last Updated
- Apr 11, 2019
Practice Location
- Address
- 1419 LEWIS ROAD
- Address 2
- SUITE 2
- City
- Edwardsville
- State
- Illinois
- ZIP Code
- 62025
- Phone
- (618) 655-3272
Authorized Official
- Name
- DR. CHRISTINE ANNE WOHLFORD, DMD
- Title
- DENTIST/MEMBER
- Phone
- (618) 655-3272
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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