| Southern Il Dental Sleep Medicine | |
|
864 Koonce Rd Murphysboro IL 62966-6048 | |
| (618) 529-2471 | |
| (618) 529-2482 |
| Full Name | Southern Il Dental Sleep Medicine |
|---|---|
| Speciality | Dentist |
| Location | 864 Koonce Rd, Murphysboro, Illinois |
| Authorized Official Name and Position | Michael R Durr (OWNER) |
| Authorized Official Contact | 6185292471 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Il Dental Sleep Medicine 864 Koonce Rd Murphysboro IL 62966-6048 Ph: (618) 529-2471 | Southern Il Dental Sleep Medicine 864 Koonce Rd Murphysboro IL 62966-6048 Ph: (618) 529-2471 |
| NPI Number | 1629407119 |
|---|---|
| Provider Enumeration Date | 11/05/2013 |
| Last Update Date | 11/05/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629407119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 060.011093 (Illinois) | Primary |