| Shiloh Family Dental | |
|
3750 Green Mount Crossing Dr O Fallon IL 62269-7293 | |
| (618) 628-7050 | |
| (618) 628-6957 |
| Full Name | Shiloh Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3750 Green Mount Crossing Dr, O Fallon, Illinois |
| Authorized Official Name and Position | Amanda Henderson (OWNER) |
| Authorized Official Contact | 6182886201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shiloh Family Dental 26 Ginger Creek Pkwy Po Box 430 Glen Carbon IL 62034-3502 Ph: (618) 288-6201 | Shiloh Family Dental 3750 Green Mount Crossing Dr O Fallon IL 62269-7293 Ph: (618) 628-7050 |
| NPI Number | 1700100930 |
|---|---|
| Provider Enumeration Date | 03/17/2010 |
| Last Update Date | 05/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700100930 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019025159 (Illinois) | Primary |
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