| Southern Illinois University Edwardsville School Of Dental Medicine | |
|
2800 College Ave Alton IL 62002-4700 | |
| (618) 474-7080 | |
| (618) 474-7029 |
| Full Name | Southern Illinois University Edwardsville School Of Dental Medicine |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2800 College Ave, Alton, Illinois |
| Authorized Official Name and Position | Debra M Schwenk (ASSOCIATE DEAN FOR CLINICAL AFFAIRS) |
| Authorized Official Contact | 6184747080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Illinois University Edwardsville School Of Dental Medicine 2800 College Ave Alton IL 62002-4700 Ph: (618) 474-7080 | Southern Illinois University Edwardsville School Of Dental Medicine 2800 College Ave Alton IL 62002-4700 Ph: (618) 474-7080 |
| NPI Number | 1215912696 |
|---|---|
| Provider Enumeration Date | 12/08/2005 |
| Last Update Date | 07/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215912696 | NPI | - | NPPES |
| 19018978 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19018978 (Illinois) | Primary |
James Reinersman Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2524 State St, Alton, IL 62002 Phone: 618-643-9523 Fax: 618-643-9523 | |
Dr. Kimberly D. Haug, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2411 Morning Star Dr, Alton, IL 62002 Phone: 618-463-7002 Fax: 618-463-7006 | |
College Avenue Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3430 College Avenue, Alton, IL 62002 Phone: 618-465-5727 Fax: 618-465-5504 | |
Affordable Dentistry Today - Alton Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3432 College Avenue, Alton, IL 62002 Phone: 618-465-5815 Fax: 618-465-5927 | |
Alton Area Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1816 Main St, Alton, IL 62002 Phone: 618-462-1081 | |
Moody Hanahan Dentistry Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4119 Humbert Rd, Alton, IL 62002 Phone: 314-477-1777 Fax: 618-462-3530 |