| |
815 N 2nd St Marshall IL 62441-1086 | |
(217) 826-5181 | |
(217) 826-2651 |
Full Name | |
---|---|
Speciality | Dentist - General Practice |
Location | 815 N 2nd St, Marshall, Illinois |
Authorized Official Name and Position | Jamie Vilk (OPERATIONS MANAGER) |
Authorized Official Contact | 2173487770 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
903 18th St. Charleston IL 61920 Ph: (217) 348-7770 | 815 N 2nd St Marshall IL 62441-1086 Ph: (217) 826-5181 |
NPI Number | 1326311630 |
---|---|
Provider Enumeration Date | 02/16/2012 |
Last Update Date | 10/01/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326311630 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |