Edwardsville Family Dentist
Edwardsville Family Dentist is a Dental Clinic/Center in Edwardsville, Illinois. Licensed in Illinois. Registered with an NPI since 2015.
- Licensed in
- IL
- In the registry since
- 2015
Practice location Address checks out
1811 Lindenwood AveEdwardsville, IL 62025-2580
Phone: (618) 659-0456
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dental Clinic/Center (primary) | Taxonomy 261QD0000X · Licence 019028093 (IL) |
|---|
Record details
| NPI number | 1063899417 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Beau Moody — Dentist/Owner · (618) 659-0456 |
| NPI enumerated | May 5, 2015 |
| Last updated in NPPES | July 24, 2023 |
| Certification date | July 24, 2023 |
| Mailing address | 1811 Lindenwood Ave, Edwardsville, IL 62025-2580 |
Other providers in Edwardsville
-
Arch View Family Dental, PLLC
2133 S State Route 157, Edwardsville, IL 62025-3691 · (618) 656-2006
-
Grand View Dental Arts, LLC
201 S Main St, Edwardsville, IL 62025-1921 · (618) 656-4202