Associated Pediatric Dentistry | |
4945 Stone Falls Ctr Ste B O Fallon IL 62269-7801 | |
(618) 622-0212 | |
Not Available |
Full Name | Associated Pediatric Dentistry |
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Speciality | Dentist - Pediatric Dentistry |
Location | 4945 Stone Falls Ctr Ste B, O Fallon, Illinois |
Authorized Official Name and Position | Lydie Fritz (BUSINESS ADMINISTRATOR) |
Authorized Official Contact | 6186222916 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Associated Pediatric Dentistry 4945 Stone Falls Ctr Ste B O Fallon IL 62269-7801 Ph: (618) 622-0212 | Associated Pediatric Dentistry 4945 Stone Falls Ctr Ste B O Fallon IL 62269-7801 Ph: (618) 622-0212 |
NPI Number | 1710450754 |
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Provider Enumeration Date | 01/02/2019 |
Last Update Date | 12/06/2021 |
Identifier | Type | State | Issuer |
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1710450754 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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