Dental Professionals of Illinois, P.c.

NPI #1689886681 in Glen Carbon, Illinois

Provider Information

NPI Number
1689886681
Entity Type
Organization
Organization Name
Dental Professionals of Illinois, P.c.
Subpart
Yes (part of a larger organization)
Parent Organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Primary Specialty
Dentist - General Practice
Enumeration Date
May 4, 2007
Last Updated
Jan 7, 2014

Practice Location

Address
4235 S STATE ROAD 159
ZIP Code
62034
Phone
(618) 288-6204

Authorized Official

Name
LINDSAY BEARDEN
Title
INS COOD
Phone
(217) 540-5100

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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