| Cedar Creek Dental Assoc | |
|
380 Suppiger Way Suite 3 Highland IL 62249-1103 | |
| (618) 654-4551 | |
| (618) 654-8523 |
| Full Name | Cedar Creek Dental Assoc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 380 Suppiger Way, Highland, Illinois |
| Authorized Official Name and Position | Bret W Gruender (PRESIDENT) |
| Authorized Official Contact | 6186544551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Creek Dental Assoc 380 Suppiger Way Suite 3 Highland IL 62249-1103 Ph: (618) 654-4551 | Cedar Creek Dental Assoc 380 Suppiger Way Suite 3 Highland IL 62249-1103 Ph: (618) 654-4551 |
| NPI Number | 1275605305 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275605305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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