institution
Southern Illinois University Carbondale
Dental Clinic/Center in Carbondale, Illinois
NPI 1962674788

Southern Illinois University Carbondale is a Dental Clinic/Center based in Carbondale, IL and is specialized in Dental. Southern Illinois University Carbondale practices in Carbondale, IL. The NPI Number for Southern Illinois University Carbondale is 1962674788 and holds a License No. 019024395 (Illinois).

The current practice location address for Southern Illinois University Carbondale is 1365 Douglas Drive, Carbondale, IL and can be reached out via phone at 618-453-2353.

Location: 1365 Douglas Drive, Carbondale, IL, 62901
institution
Provider Profile Details
NPI Number
1962674788
Provider Name
Southern Illinois University Carbondale
Credential
Provider Entity Type
Organization
Address
1365 Douglas Drive, Carbondale, IL, 62901
Phone Number
618-453-2353
Fax Number
Provider Enumeration Date
04/01/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1184615866 05 IL
019.032439 05 IL
1295716959 05 IL
1023008364 05 IL
institution
Provider Business Practice Location Address Details
Address
1365 Douglas Drive
City
State
Zip
62901
Phone Number
618-453-2353
Fax Number
person
Provider Business Mailing Address Details
Address
1365 Douglas Drive
City
State
Zip
62901
Phone Number
618-453-2353
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
License No.
019024395 (Illinois)
Definition
Definition to come...
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