| Sipd Godfrey, Pllc | |
|
901 Lars Hoffman Xing Godfrey IL 62035-4217 | |
| (618) 481-3700 | |
| Not Available |
| Full Name | Sipd Godfrey, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 901 Lars Hoffman Xing, Godfrey, Illinois |
| Authorized Official Name and Position | Christine A Wohlford (MEMBER/ OWNER) |
| Authorized Official Contact | 6187912794 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sipd Godfrey, Pllc 1004 Timberlake Dr Edwardsville IL 62025-4100 Ph: (618) 791-2794 | Sipd Godfrey, Pllc 901 Lars Hoffman Xing Godfrey IL 62035-4217 Ph: (618) 481-3700 |
| NPI Number | 1902669955 |
|---|---|
| Provider Enumeration Date | 02/02/2024 |
| Last Update Date | 02/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902669955 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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