| Taube Family Dental | |
|
104 E Main St Mascoutah IL 62258-2135 | |
| (618) 566-7384 | |
| (618) 566-4290 |
| Full Name | Taube Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 104 E Main St, Mascoutah, Illinois |
| Authorized Official Name and Position | Erik Taube (OWNER) |
| Authorized Official Contact | 6185667384 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Taube Family Dental 104 E Main St Po Box 142 Mascoutah IL 62258-2135 Ph: (618) 566-7384 | Taube Family Dental 104 E Main St Mascoutah IL 62258-2135 Ph: (618) 566-7384 |
| NPI Number | 1073968509 |
|---|---|
| Provider Enumeration Date | 05/03/2016 |
| Last Update Date | 05/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073968509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019022047 (Illinois) | Secondary |
| 122300000X | Dentist | 019029166 (Illinois) | Primary |