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1750609418
GRANITE CITY DENTAL CARE LTD
CHAMPAIGN, IL
NPI
1750609418
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Entity Type
Organization
Authorized Contact
LA NAE WOOD
Office Manager
217-351-2650
Organization Subpart ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: IL 019.0225511)
Enumeration Date
2010-05-05
Last Update Date
2010-05-05
Business Address
GRANITE CITY DENTAL CARE LTD
2102 N MARKET ST
CHAMPAIGN, IL 61822-1306
Phone number: 618-877-0780
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Mailing Address
GRANITE CITY DENTAL CARE LTD
2130 JOHNSON RD
GRANITE CITY, IL 62040-3961
Phone number: 618-877-0780
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