| Dr Brian C Back, DMD | |
|
104 E Main St, Mascoutah, IL 62258-2135 | |
| (618) 566-7384 | |
| (618) 566-4290 |
| Full Name | Dr Brian C Back |
|---|---|
| Gender | Male |
| Speciality | Dentist - General Practice |
| Location | 104 E Main St, Mascoutah, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053565218 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019027792 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Brian C Back, DMD 104 E Main St, P.o. Box 142, Mascoutah, IL 62258-2135 Ph: (618) 566-7384 | Dr Brian C Back, DMD 104 E Main St, Mascoutah, IL 62258-2135 Ph: (618) 566-7384 |
Dennis Henry Knobeloch, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1324 West Main Street, Mascoutah, IL 62258 Phone: 618-566-8884 | |
Randy A Parmlee, DMD Dentist Medicare: Medicare Enrolled Practice Location: 104 E Main, Mascoutah, IL 62258 Phone: 618-566-7384 | |
Dr. Erik Vineyard Taube, DMD Dentist Medicare: Medicare Enrolled Practice Location: 104 E Main St, Mascoutah, IL 62258 Phone: 618-566-7384 |