| Lewis And Clark Community College Dental Hygiene Clinic | |
|
5800 Godfrey Rd Godfrey IL 62035-2466 | |
| (618) 468-4463 | |
| (618) 468-4408 |
| Full Name | Lewis And Clark Community College Dental Hygiene Clinic |
|---|---|
| Speciality | Dentist |
| Location | 5800 Godfrey Rd, Godfrey, Illinois |
| Authorized Official Name and Position | John Randall Miller (CLINIC SUPERVISOR) |
| Authorized Official Contact | 6184684414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lewis And Clark Community College Dental Hygiene Clinic 5800 Godfrey Rd Godfrey IL 62035-2466 Ph: (618) 468-4463 | Lewis And Clark Community College Dental Hygiene Clinic 5800 Godfrey Rd Godfrey IL 62035-2466 Ph: (618) 468-4463 |
| NPI Number | 1497746077 |
|---|---|
| Provider Enumeration Date | 11/02/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497746077 | NPI | - | NPPES |
| 9176253 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Illinois) | Primary |
Dentistry With Tlc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1317 Dadrian Professional Park, Godfrey, IL 62035 Phone: 618-466-0733 Fax: 618-466-1433 | |
Dentistry With Tlc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1317 Dadrian Professional Park, Godfrey, IL 62035 Phone: 618-466-0733 Fax: 618-466-1433 | |
Acclaimed Orthodontic Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3011 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-7966 | |
All Smiles Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3003 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-5508 Fax: 618-466-3515 | |
Sipd Godfrey, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 Lars Hoffman Xing, Godfrey, IL 62035 Phone: 618-481-3700 |