John A. Logan College | |
700 Logan College Dr Carterville IL 62918-2500 | |
(618) 985-2828 | |
(618) 985-4654 |
Full Name | John A. Logan College |
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Speciality | Dentist |
Location | 700 Logan College Dr, Carterville, Illinois |
Authorized Official Name and Position | Pam Ruth Karns (DEPARTMENT CHAIR FOR ALLIED HEALTH) |
Authorized Official Contact | 6189852828 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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John A. Logan College 700 Logan College Dr Carterville IL 62918-2500 Ph: (618) 985-2828 | John A. Logan College 700 Logan College Dr Carterville IL 62918-2500 Ph: (618) 985-2828 |
NPI Number | 1598055741 |
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Provider Enumeration Date | 04/08/2011 |
Last Update Date | 04/08/2011 |
Identifier | Type | State | Issuer |
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1598055741 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 019.018274 (Illinois) | Primary |
Carterville Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 N Division St, Carterville, IL 62918 Phone: 618-985-3515 Fax: 618-985-3986 | |
Carterville Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 South Division, Carterville, IL 62918 Phone: 618-985-4200 Fax: 618-985-4137 |