Siu Dental Associates

NPI #1659957850 in Edwardsville, Illinois

Provider Information

NPI Number: 1659957850
Entity Type: Organization
Organization Name: Siu Dental Associates
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 19, 2021
Last Updated: Sep 19, 2024

Practice Location

Address: 195 UNIVERSITY PARK DR
City: Edwardsville
State: Illinois
ZIP Code: 62025-3645
Phone: (618) 650-5781

Authorized Official

Name: ELIZABETH NOEL PHELPS
Title: BUSINESS MANAGER
Phone: (618) 474-7104

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Dentist - Oral and Maxillofacial Pathology — Oral and Maxillofacial Pathology	1223P0106X
Dentist - General Practice — General Practice	1223G0001X	Primary

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