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1365 Douglas Dr College Of Applied Sciences/school Of Allied Health Carbondale IL 62901-6615 | |
| (618) 453-7241 | |
| (618) 453-7020 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1365 Douglas Dr, Carbondale, Illinois |
| Authorized Official Name and Position | Ronda Demattei (ASSOC. PROF./DENTAL HYGIENE PROGRAM) |
| Authorized Official Contact | 6184537298 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1365 Douglas Dr College Of Applied Sciences/school Of Allied Health Carbondale IL 62901-6615 Ph: (618) 453-7241 | 1365 Douglas Dr College Of Applied Sciences/school Of Allied Health Carbondale IL 62901-6615 Ph: (618) 453-7241 |
| NPI Number | 1720250939 |
|---|---|
| Provider Enumeration Date | 03/27/2008 |
| Last Update Date | 03/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720250939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Illinois) | Primary |
Southern Illinois University Carbondale Dental Sealant Program Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1365 Douglas Dr Rm 18, Casa, Sah, Mc 6615, Carbondale, IL 62901 Phone: 618-453-7211 Fax: 618-453-7020 | |
Oakland Dental Care P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 S Oakland Ave, Carbondale, IL 62901 Phone: 618-549-2166 Fax: 618-529-4128 | |
Little Egypt Pediatric Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1255 Cedar Ct, Carbondale, IL 62901 Phone: 618-319-4536 |