Restoration Dental LLC - Charleston Family Dental
NPI #1780957092 in Charleston, Illinois
Provider Information
- NPI Number
- 1780957092
- Entity Type
- Organization
- Organization Name
- Restoration Dental LLC - Charleston Family Dental
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 16, 2012
- Last Updated
- Oct 1, 2015
Practice Location
- Address
- 903 18TH ST
- City
- Charleston
- State
- Illinois
- ZIP Code
- 61920-2938
- Phone
- (217) 348-7770
Authorized Official
- Name
- JAMIE VILK
- Title
- OPERATIONS MANAGER
- Phone
- (217) 348-7770
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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