| Signature Family Dental | |
|
1170 Belt Line Rd Collinsville IL 62234-4372 | |
| (618) 345-1400 | |
| Not Available |
| Full Name | Signature Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 1170 Belt Line Rd, Collinsville, Illinois |
| Authorized Official Name and Position | Heather Danielle Mahassek (OWNER) |
| Authorized Official Contact | 6187092934 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Signature Family Dental 1170 Belt Line Rd Collinsville IL 62234-4372 Ph: (618) 345-1400 | Signature Family Dental 1170 Belt Line Rd Collinsville IL 62234-4372 Ph: (618) 345-1400 |
| NPI Number | 1306401591 |
|---|---|
| Provider Enumeration Date | 05/03/2019 |
| Last Update Date | 05/03/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306401591 | NPI | - | NPPES |
| 1003291162 | Other | IL | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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