| Humbert Road Dentistry | |
|
4119 Humbert Rd Alton IL 62002-7116 | |
| (618) 465-8100 | |
| (618) 462-3530 |
| Full Name | Humbert Road Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 4119 Humbert Rd, Alton, Illinois |
| Authorized Official Name and Position | Dawn Michelle Shudt (OFFICE MANAGER) |
| Authorized Official Contact | 6184658100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Humbert Road Dentistry 4119 Humbert Rd Alton IL 62002-7116 Ph: (618) 465-8100 | Humbert Road Dentistry 4119 Humbert Rd Alton IL 62002-7116 Ph: (618) 465-8100 |
| NPI Number | 1942501911 |
|---|---|
| Provider Enumeration Date | 11/08/2010 |
| Last Update Date | 11/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942501911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019028117 (Illinois) | Secondary |
| 122300000X | Dentist | 19020630 (Illinois) | Secondary |
| 122300000X | Dentist | 019013894 (Illinois) | Primary |
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Affordable Dentistry Today - Alton Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3432 College Avenue, Alton, IL 62002 Phone: 618-465-5815 Fax: 618-465-5927 | |
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