| Corporation | |
|
111 South First Street Effingham IL 62401 | |
| (217) 342-4494 | |
| (217) 347-5344 |
| Full Name | Corporation |
|---|---|
| Speciality | Dentist |
| Location | 111 South First Street, Effingham, Illinois |
| Authorized Official Name and Position | Ted Koester (DMD) |
| Authorized Official Contact | 2173424494 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Corporation 111 South First Street Effingham IL 62401 Ph: (217) 342-4494 | Corporation 111 South First Street Effingham IL 62401 Ph: (217) 342-4494 |
| NPI Number | 1578633665 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578633665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Illinois) | Primary |
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