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1200 Network Centre Drive Suite #2 Effingham IL 62401 | |
(217) 540-8946 | |
(217) 540-8946 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 1200 Network Centre Drive, Effingham, Illinois |
Authorized Official Name and Position | Brittany Nichelle Howard (CREDENTIALING AFFILIATION COORDINAT) |
Authorized Official Contact | 2175408946 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1200 Network Centre Drive Suite #2 Effingham IL 62401 Ph: (217) 540-8946 | 1200 Network Centre Drive Suite #2 Effingham IL 62401 Ph: (217) 540-8946 |
NPI Number | 1093140501 |
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Provider Enumeration Date | 09/04/2013 |
Last Update Date | 08/13/2019 |
Identifier | Type | State | Issuer |
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1093140501 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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