| Glen Carbon Family Dentistry | |
|
4235 S State Road 159 Glen Carbon IL 62034 | |
| (618) 288-6204 | |
| (618) 288-6268 |
| Full Name | Glen Carbon Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4235 S State Road 159, Glen Carbon, Illinois |
| Authorized Official Name and Position | Lindsay Bearden (INS COOD) |
| Authorized Official Contact | 2175405100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glen Carbon Family Dentistry 4235 S State Road 159 Glen Carbon IL 62034 Ph: (618) 288-6204 | Glen Carbon Family Dentistry 4235 S State Road 159 Glen Carbon IL 62034 Ph: (618) 288-6204 |
| NPI Number | 1689886681 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 01/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689886681 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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