institution
Moody Hanahan Dentistry Llc
Dental Clinic/Center in Alton, Illinois
NPI 1528693926

Moody Hanahan Dentistry Llc is a Dental Clinic/Center based in Alton, IL and is specialized in Dental. Moody Hanahan Dentistry Llc practices in Alton, IL. The NPI Number for Moody Hanahan Dentistry Llc is 1528693926 and holds a License No. (Illinois).

The current practice location address for Moody Hanahan Dentistry Llc is 4119 Humbert Rd, Alton, IL and can be reached out via phone at 314-477-1777 and via fax at 618-462-3530. You can also correspond with Moody Hanahan Dentistry Llc through the mailing address at 4119 HUMBERT RD, ALTON, IL - 62002-7116 (mailing address contact number: 314-477-1777).

Location: 4119 Humbert Rd, Alton, IL, 62002-7116
institution
Provider Profile Details
NPI Number
1528693926
Provider Name
Moody Hanahan Dentistry Llc
Credential
Provider Entity Type
Organization
Address
4119 Humbert Rd, Alton, IL, 62002-7116
Phone Number
314-477-1777
Fax Number
618-462-3530
Provider Enumeration Date
03/05/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1740703149 01 SARA HANAHAN - INDIVIDUAL NPI
1700984317 01 STACY MOODY - INDIVIDUAL NPI
institution
Provider Business Practice Location Address Details
Address
4119 Humbert Rd
City
State
Zip
62002-7116
Phone Number
314-477-1777
Fax Number
618-462-3530
person
Provider Business Mailing Address Details
Address
4119 Humbert Rd
City
State
Zip
62002-7116
Phone Number
314-477-1777
Fax Number
618-462-3530
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
License No.
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Definition
Definition to come...
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