PERIODONTICS OF SOUTHERN ILLINOIS

BELLEVILLE, IL
NPI1639224876
Entity TypeOrganization
Authorized ContactJOSEPJ A RENNER
Owner
618-233-7300
Organization Subpart ?No
Primary Taxonomy1223P0300X Dentist, Periodontics
(Licence: IL  019018213)
Additional Taxonomies1223P0300X Dentist, Periodontics
(Licence: IL  019022757)
1223P0300X Dentist, Periodontics
(Licence: IL  019025731)
Enumeration Date2007-01-25
Last Update Date2020-08-22
Business Address
PERIODONTICS OF SOUTHERN ILLINOIS
#11 PARK PLACE
BELLEVILLE, IL 62226-2925
Phone number: 618-233-7300
Mailing Address
PERIODONTICS OF SOUTHERN ILLINOIS
#11 PARK PLACE
BELLEVILLE, IL 62226-2925
Phone number: 618-233-7300
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