| Associated Pediatric Dentistry Ltd | |
|
4945 Stone Falls Ctr Suite B O Fallon IL 62269-7802 | |
| (618) 622-0212 | |
| (618) 622-1996 |
| Full Name | Associated Pediatric Dentistry Ltd |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4945 Stone Falls Ctr, O Fallon, Illinois |
| Authorized Official Name and Position | Kevin Charles Beyersdorfer (OWNER DENTIST) |
| Authorized Official Contact | 6186220212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Associated Pediatric Dentistry Ltd 4945 Stone Falls Ctr Suite B O Fallon IL 62269-7802 Ph: (618) 622-0212 | Associated Pediatric Dentistry Ltd 4945 Stone Falls Ctr Suite B O Fallon IL 62269-7802 Ph: (618) 622-0212 |
| NPI Number | 1952497901 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952497901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (Illinois) | Primary |
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