| Loren G. Wilson D.d.s. P.c. | |
|
1030 4th St Eldorado IL 62930-1702 | |
| (618) 273-9684 | |
| (618) 273-7107 |
| Full Name | Loren G. Wilson D.d.s. P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1030 4th St, Eldorado, Illinois |
| Authorized Official Name and Position | Loren Wilson (PRESIDENT) |
| Authorized Official Contact | 6182739684 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Loren G. Wilson D.d.s. P.c. 670 Bixler Rd Eldorado IL 62930-3786 Ph: (618) 273-9684 | Loren G. Wilson D.d.s. P.c. 1030 4th St Eldorado IL 62930-1702 Ph: (618) 273-9684 |
| NPI Number | 1275674426 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275674426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |
Southern Illinois Family Dentistry Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1030 4th St, Eldorado, IL 62930 Phone: 618-273-9361 |