| Borden Dental Arts | |
|
201 S Main St Edwardsville IL 62025-1921 | |
| (618) 656-4202 | |
| (618) 656-6580 |
| Full Name | Borden Dental Arts |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 201 S Main St, Edwardsville, Illinois |
| Authorized Official Name and Position | Charles Seymour Borden (OWNER) |
| Authorized Official Contact | 6186564202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Borden Dental Arts 201 S Main St Edwardsville IL 62025-1921 Ph: (618) 656-4202 | Borden Dental Arts 201 S Main St Edwardsville IL 62025-1921 Ph: (618) 656-4202 |
| NPI Number | 1033631882 |
|---|---|
| Provider Enumeration Date | 07/13/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033631882 | NPI | - | NPPES |
| 1649322561 | Other | IL | GENERAL DENTIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019024683 (Illinois) | Primary |
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