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1317 Dadrian Professional Park Godfrey IL 62035-1686 | |
| (618) 466-0733 | |
| (618) 466-1433 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1317 Dadrian Professional Park, Godfrey, Illinois |
| Authorized Official Name and Position | Larry Pruett (OFFICE MANAGER) |
| Authorized Official Contact | 6184660733 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1317 D' Adrian Professional Park Godfrey IL 62035 Ph: (618) 466-0733 | 1317 Dadrian Professional Park Godfrey IL 62035-1686 Ph: (618) 466-0733 |
| NPI Number | 1215034608 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215034608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |
All Smiles Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3003 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-5508 Fax: 618-466-3515 | |
Sipd Godfrey, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 Lars Hoffman Xing, Godfrey, IL 62035 Phone: 618-481-3700 |