Premier Dental of Mt Vernon PC

NPI #1932479235 in Mount Vernon, Illinois

Provider Information

NPI Number: 1932479235
Entity Type: Organization
Organization Name: Premier Dental of Mt Vernon PC
Primary Specialty: Dentist
Enumeration Date: Jan 4, 2012
Last Updated: Jan 4, 2012

Practice Location

Address: 9 CUSUMANO PROFESSIONAL PLAZA DR
City: Mount Vernon
State: Illinois
ZIP Code: 62864-6736
Phone: (618) 315-6213

Authorized Official

Name: DR. CARLA GEHA, DMD
Title: PRESIDENT/DENTIST
Phone: (618) 315-6213

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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