Spring Valley Dental Associates Llc | |
904 E Highway 50 O Fallon IL 62269-2868 | |
(186) 632-8471 | |
Not Available |
Full Name | Spring Valley Dental Associates Llc |
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Speciality | Dentist |
Location | 904 E Highway 50, O Fallon, Illinois |
Authorized Official Name and Position | Diana Lifritz (OPERATIONS MANAGER OF CREDENTIALING) |
Authorized Official Contact | 6365785027 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Spring Valley Dental Associates Llc 1922 Edwardsville Club Plaza Ct Edwardsville IL 62025-3717 Ph: (888) 502-7339 | Spring Valley Dental Associates Llc 904 E Highway 50 O Fallon IL 62269-2868 Ph: (186) 632-8471 |
NPI Number | 1154040830 |
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Provider Enumeration Date | 08/25/2022 |
Last Update Date | 08/25/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154040830 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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