| Edwardsville Oral Surgery And Implant Center | |
|
1005 Plummer Dr Suite A Edwardsville IL 62025-4702 | |
| (618) 656-3100 | |
| (618) 656-3146 |
| Full Name | Edwardsville Oral Surgery And Implant Center |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1005 Plummer Dr, Edwardsville, Illinois |
| Authorized Official Name and Position | Steven Joseph Hyten (OWNER) |
| Authorized Official Contact | 6186563100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edwardsville Oral Surgery And Implant Center 1005 Plummer Dr Suite A Edwardsville IL 62025-4702 Ph: (618) 656-3100 | Edwardsville Oral Surgery And Implant Center 1005 Plummer Dr Suite A Edwardsville IL 62025-4702 Ph: (618) 656-3100 |
| NPI Number | 1245346097 |
|---|---|
| Provider Enumeration Date | 08/22/2006 |
| Last Update Date | 08/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245346097 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 021.002165 (Illinois) | Primary |
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Edwardsville Family Dentist Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1811 Lindenwood Ave, Edwardsville, IL 62025 Phone: 618-659-0456 | |
Katharine Mcginnis D.m.d. P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 235 A. South Main St, Edwardsville, IL 62025 Phone: 618-656-0451 Fax: 618-656-9130 | |
Kenneth C Hyten & David W Hyten Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2110 Troy Rd, Suite A, Edwardsville, IL 62025 Phone: 618-656-1914 Fax: 618-656-2053 |