Effingham Family Dental Ltd | |
310 W Jefferson Ave Effingham IL 62401-2348 | |
(217) 342-3850 | |
(217) 342-3891 |
Full Name | Effingham Family Dental Ltd |
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Speciality | Dentist - General Practice |
Location | 310 W Jefferson Ave, Effingham, Illinois |
Authorized Official Name and Position | Jeffrey Roger Stevenson (DENTIST) |
Authorized Official Contact | 2173423850 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Effingham Family Dental Ltd 310 W Jefferson Ave Effingham IL 62401-2348 Ph: (217) 342-3850 | Effingham Family Dental Ltd 310 W Jefferson Ave Effingham IL 62401-2348 Ph: (217) 342-3850 |
NPI Number | 1588100325 |
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Provider Enumeration Date | 01/18/2017 |
Last Update Date | 01/18/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588100325 | NPI | - | NPPES |
1437378098 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 019023431 (Illinois) | Primary |
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