| Chester Smile Center | |
|
1101 Opdyke St Chester IL 62233-2004 | |
| (618) 826-4440 | |
| (618) 826-5799 |
| Full Name | Chester Smile Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1101 Opdyke St, Chester, Illinois |
| Authorized Official Name and Position | Michael Peter Holub (DOCTOR) |
| Authorized Official Contact | 6188264440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chester Smile Center 1101 Opdyke St Chester IL 62233-2004 Ph: (618) 826-4440 | Chester Smile Center 1101 Opdyke St Chester IL 62233-2004 Ph: (618) 826-4440 |
| NPI Number | 1346552247 |
|---|---|
| Provider Enumeration Date | 07/08/2010 |
| Last Update Date | 07/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346552247 | NPI | - | NPPES |
| 1002247 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019022619 (Illinois) | Primary |
Chester Family Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1654 State St, Chester, IL 62233 Phone: 618-826-5017 Fax: 618-806-5019 |