| Kyle R Childers Dmd Ms Pc | |
|
201 W Washington St Benton IL 62812 | |
| (618) 438-2815 | |
| (618) 439-6127 |
| Full Name | Kyle R Childers Dmd Ms Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 201 W Washington St, Benton, Illinois |
| Authorized Official Name and Position | Kyle Ray Childers (OWNER) |
| Authorized Official Contact | 6184382815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle R Childers Dmd Ms Pc 201 W Washington St Benton IL 62812 Ph: (618) 438-2815 | Kyle R Childers Dmd Ms Pc 201 W Washington St Benton IL 62812 Ph: (618) 438-2815 |
| NPI Number | 1497897284 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497897284 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (Illinois) | Primary |
Dawn A Jackson-breeden Dmd Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 405 E Park St, Benton, IL 62812 Phone: 618-439-4391 |