Southern Illinois University Carbondale Dental Sealant Program | |
1365 Douglas Dr Rm 18 Casa, Sah, Mc 6615 Carbondale IL 62901-2583 | |
(618) 453-7211 | |
(618) 453-7020 |
Full Name | Southern Illinois University Carbondale Dental Sealant Program |
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Speciality | Clinic/center - Dental |
Location | 1365 Douglas Dr Rm 18, Carbondale, Illinois |
Authorized Official Name and Position | Faith Miller (DENTAL SEALANT PROGRAM CO-COORDINAT) |
Authorized Official Contact | 6184537211 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Southern Illinois University Carbondale Dental Sealant Program 1365 Douglas Dr Rm 18 Casa, Sah, Mc 6615 Carbondale IL 62901-2583 Ph: (618) 453-7211 | Southern Illinois University Carbondale Dental Sealant Program 1365 Douglas Dr Rm 18 Casa, Sah, Mc 6615 Carbondale IL 62901-2583 Ph: (618) 453-7211 |
NPI Number | 1053582189 |
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Provider Enumeration Date | 03/17/2008 |
Last Update Date | 03/17/2008 |
Identifier | Type | State | Issuer |
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1053582189 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Oakland Dental Care P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 S Oakland Ave, Carbondale, IL 62901 Phone: 618-549-2166 Fax: 618-529-4128 | |
Little Egypt Pediatric Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1255 Cedar Ct, Carbondale, IL 62901 Phone: 618-319-4536 |