| The Dental Studio Of Southern Illinois | |
| 
					741 W State St Ste 1 O Fallon IL 62269-1971  | |
| (618) 632-2282 | |
| Not Available | 
| Full Name | The Dental Studio Of Southern Illinois | 
|---|---|
| Speciality | Clinic/center - Dental | 
| Location | 741 W State St Ste 1, O Fallon, Illinois | 
| Authorized Official Name and Position | Brittany Gilbreth (CO-OWNER) | 
| Authorized Official Contact | 6183040998 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| The Dental Studio Of Southern Illinois 741 W State St Ste 1 O Fallon IL 62269-1971 Ph: () -  | The Dental Studio Of Southern Illinois 741 W State St Ste 1 O Fallon IL 62269-1971 Ph: (618) 632-2282  | 
| NPI Number | 1598408783 | 
|---|---|
| Provider Enumeration Date | 04/15/2022 | 
| Last Update Date | 05/01/2022 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1598408783 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary | 
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