West End Family Dental

NPI 1023448891 - Dentist - 1223G0001X

NPI Details
NPI 1023448891
Enumeration Date 11/15/2013
Last Updated 11/15/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name DAVID DAVID
Position OWNER
Phone (618) 692-1110
Fax
Practice Location
24 GINGER CREEK PKWY
GLEN CARBON IL, 62034-3502, US
Phone (618) 692-1110
Fax
Business Location
6911 W MAIN ST
BELLEVILLE IL, 62223-3029, US
Phone (618) 397-5000
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Illinois
License Number 019025281
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According to our database, West End Family Dental NPI is 1023448891, taxonomy code is 1223G0001X and license number is 019025281, license state is located at Illinois. West End Family Dental physically located at 24 Ginger Creek Pkwy, Glen Carbon IL, 62034-3502. NPI Number 1033115704 has the healthcare provider type.

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1023448891 NPI number is provided on an as is basis without warranty of any kind. 1023448891 is maintained by the National Plan & Provider Enumeration System. The contents of West End Family Dental are for informational purposes only.