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Southern Illinois University Edwardsville School Of Dental Medicine
General Practice Dentistry in Alton, Illinois
NPI 1215912696

Southern Illinois University Edwardsville School Of Dental Medicine is a General Practice Dentistry based in Alton, IL and is specialized in General Practice. Southern Illinois University Edwardsville School Of Dental Medicine practices in Alton, IL. The NPI Number for Southern Illinois University Edwardsville School Of Dental Medicine is 1215912696 and holds a License No. 19018978 (Illinois).

The current practice location address for Southern Illinois University Edwardsville School Of Dental Medicine is 2800 College Ave, Alton, IL and can be reached out via phone at 618-474-7080 and via fax at 618-474-7029.

Location: 2800 College Ave, Alton, IL, 62002-4700
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1215912696
Provider Name
Southern Illinois University Edwardsville School Of Dental Medicine
Credential
Provider Entity Type
Organization
Address
2800 College Ave, Alton, IL, 62002-4700
Phone Number
618-474-7080
Fax Number
618-474-7029
Provider Enumeration Date
12/08/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
19018978 05 IL
institution
Provider Business Practice Location Address Details
Address
2800 College Ave
City
Alton
State
Illinois
Zip
62002-4700
Phone Number
618-474-7080
Fax Number
618-474-7029
person
Provider Business Mailing Address Details
Address
2800 College Ave
City
Alton
State
Illinois
Zip
62002-4700
Phone Number
618-474-7080
Fax Number
618-474-7029
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
19018978 (Illinois)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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