Southern Il Dental Sleep Medicine

NPI #1629407119 in Murphysboro, Illinois

Provider Information

NPI Number: 1629407119
Entity Type: Organization
Organization Name: Southern Il Dental Sleep Medicine
Primary Specialty: Dentist
Enumeration Date: Nov 5, 2013
Last Updated: Nov 5, 2013

Practice Location

Address: 864 KOONCE RD
City: Murphysboro
State: Illinois
ZIP Code: 62966-6048
Phone: (618) 529-2471

Authorized Official

Name: MICHAEL R DURR, DMD
Title: OWNER
Phone: (618) 529-2471

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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