Taube Family Dental | |
104 E Main St Mascoutah IL 62258-2135 | |
(618) 566-7384 | |
(618) 566-4290 |
Full Name | Taube Family Dental |
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Speciality | Dentist |
Location | 104 E Main St, Mascoutah, Illinois |
Authorized Official Name and Position | Erik Taube (OWNER) |
Authorized Official Contact | 6185667384 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Taube Family Dental 104 E Main St Po Box 142 Mascoutah IL 62258-2135 Ph: (618) 566-7384 | Taube Family Dental 104 E Main St Mascoutah IL 62258-2135 Ph: (618) 566-7384 |
NPI Number | 1073968509 |
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Provider Enumeration Date | 05/03/2016 |
Last Update Date | 05/03/2016 |
Identifier | Type | State | Issuer |
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1073968509 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 019029166 (Illinois) | Primary |
122300000X | Dentist | 019022047 (Illinois) | Secondary |