| Spring Valley Dental Group Ltd | |
|
904 E Highway 50 O Fallon IL 62269 | |
| (618) 632-8471 | |
| (618) 632-7130 |
| Full Name | Spring Valley Dental Group Ltd |
|---|---|
| Speciality | Dentist |
| Location | 904 E Highway 50, O Fallon, Illinois |
| Authorized Official Name and Position | Aaron V Oge (CORP SEC) |
| Authorized Official Contact | 6186328471 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spring Valley Dental Group Ltd 904 E Highway 50 O Fallon IL 62269 Ph: (618) 632-8471 | Spring Valley Dental Group Ltd 904 E Highway 50 O Fallon IL 62269 Ph: (618) 632-8471 |
| NPI Number | 1013008978 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013008978 | NPI | - | NPPES |
| 507401 | Other | UNITED CONCORDIA INS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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