| Houseman Dental Office Inc. | |
|
308 S Washington St Jerseyville IL 62052-1672 | |
| (618) 498-3621 | |
| (618) 498-3429 |
| Full Name | Houseman Dental Office Inc. |
|---|---|
| Speciality | Dentist |
| Location | 308 S Washington St, Jerseyville, Illinois |
| Authorized Official Name and Position | John Henry Houseman (PRINCIPAL) |
| Authorized Official Contact | 6184983621 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Houseman Dental Office Inc. 308 S Washington St Jerseyville IL 62052-1672 Ph: (618) 498-3621 | Houseman Dental Office Inc. 308 S Washington St Jerseyville IL 62052-1672 Ph: (618) 498-3621 |
| NPI Number | 1770837544 |
|---|---|
| Provider Enumeration Date | 11/01/2012 |
| Last Update Date | 11/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770837544 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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