| St. Louis Surgical Associates, Llc | |
|
24 Ginger Creek Pkwy Glen Carbon IL 62034-3502 | |
| (618) 655-1580 | |
| Not Available |
| Full Name | St. Louis Surgical Associates, Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 24 Ginger Creek Pkwy, Glen Carbon, Illinois |
| Authorized Official Name and Position | David Guilbeault (OWNER) |
| Authorized Official Contact | 6186439523 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Louis Surgical Associates, Llc 24 Ginger Creek Pkwy Glen Carbon IL 62034-3502 Ph: () - | St. Louis Surgical Associates, Llc 24 Ginger Creek Pkwy Glen Carbon IL 62034-3502 Ph: (618) 655-1580 |
| NPI Number | 1093064057 |
|---|---|
| Provider Enumeration Date | 09/06/2012 |
| Last Update Date | 11/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093064057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 19025397 (Illinois) | Primary |
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