| Bauerhite Orthodontic Specialists, Pc | |
|
23 Glen Ed Professional Park Glen Carbon IL 62034-3333 | |
| (618) 692-1044 | |
| (618) 692-6809 |
| Full Name | Bauerhite Orthodontic Specialists, Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 23 Glen Ed Professional Park, Glen Carbon, Illinois |
| Authorized Official Name and Position | Paula G Wilson (FINANCIAL COORDINATOR) |
| Authorized Official Contact | 6186921044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bauerhite Orthodontic Specialists, Pc 23 Glen Ed Professional Park Glen Carbon IL 62034-3333 Ph: (618) 692-1044 | Bauerhite Orthodontic Specialists, Pc 23 Glen Ed Professional Park Glen Carbon IL 62034-3333 Ph: (618) 692-1044 |
| NPI Number | 1841526290 |
|---|---|
| Provider Enumeration Date | 10/20/2009 |
| Last Update Date | 02/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841526290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 003853 (Illinois) | Primary |
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