Loren G. Wilson D.d.s. P.c. | |
1030 4th St Eldorado IL 62930-1702 | |
(618) 273-9684 | |
(618) 273-7107 |
Full Name | Loren G. Wilson D.d.s. P.c. |
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Speciality | Dentist - General Practice |
Location | 1030 4th St, Eldorado, Illinois |
Authorized Official Name and Position | Loren Wilson (PRESIDENT) |
Authorized Official Contact | 6182739684 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Loren G. Wilson D.d.s. P.c. 670 Bixler Rd Eldorado IL 62930-3786 Ph: (618) 273-9684 | Loren G. Wilson D.d.s. P.c. 1030 4th St Eldorado IL 62930-1702 Ph: (618) 273-9684 |
NPI Number | 1275674426 |
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Provider Enumeration Date | 02/09/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1275674426 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (Illinois) | Primary |