| Sesser Dental Clinic | |
|
6294 State Highway 154 Sesser Dental Clinic Sesser IL 62884-2163 | |
| (618) 625-6979 | |
| (618) 625-5362 |
| Full Name | Sesser Dental Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 6294 State Highway 154, Sesser, Illinois |
| Authorized Official Name and Position | Kim A Mitroka (PRESIDENT CEO) |
| Authorized Official Contact | 6187242436 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sesser Dental Clinic Po Box 155 Rca Clinic Christopher IL 62822 Ph: (618) 724-2401 | Sesser Dental Clinic 6294 State Highway 154 Sesser Dental Clinic Sesser IL 62884-2163 Ph: (618) 625-6979 |
| NPI Number | 1861547705 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 01/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861547705 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |