| Premier Dental Of Mt Vernon Pc | |
|
9 Cusumano Professional Plaza Dr Mount Vernon IL 62864-6736 | |
| (618) 315-6213 | |
| Not Available |
| Full Name | Premier Dental Of Mt Vernon Pc |
|---|---|
| Speciality | Dentist |
| Location | 9 Cusumano Professional Plaza Dr, Mount Vernon, Illinois |
| Authorized Official Name and Position | Carla Geha (PRESIDENT/DENTIST) |
| Authorized Official Contact | 6183156213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Dental Of Mt Vernon Pc Po Box 1003 Mount Vernon IL 62864-0021 Ph: (618) 315-6213 | Premier Dental Of Mt Vernon Pc 9 Cusumano Professional Plaza Dr Mount Vernon IL 62864-6736 Ph: (618) 315-6213 |
| NPI Number | 1932479235 |
|---|---|
| Provider Enumeration Date | 01/04/2012 |
| Last Update Date | 01/04/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932479235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019028108 (Illinois) | Primary |
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