| Stone Falls Dental Care, Llc | |
|
4945 Stone Falls Ctr Suite A O Fallon IL 62269-7801 | |
| (618) 624-2800 | |
| (618) 551-2288 |
| Full Name | Stone Falls Dental Care, Llc |
|---|---|
| Speciality | Dentist |
| Location | 4945 Stone Falls Ctr, O Fallon, Illinois |
| Authorized Official Name and Position | Carleigh Prane (OWNER) |
| Authorized Official Contact | 6186242800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stone Falls Dental Care, Llc 4945 Stone Falls Ctr Suite A O Fallon IL 62269-7801 Ph: (618) 624-2800 | Stone Falls Dental Care, Llc 4945 Stone Falls Ctr Suite A O Fallon IL 62269-7801 Ph: (618) 624-2800 |
| NPI Number | 1174945158 |
|---|---|
| Provider Enumeration Date | 01/10/2014 |
| Last Update Date | 07/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174945158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 19026282 (Illinois) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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