Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Maryville Family Dental

Organization Dentist · NPI 1639405731

Maryville Family Dental is a Dentist in Maryville, Illinois. Licensed in Illinois. Registered with an NPI since 2009.

Licensed in
IL
In the registry since
2009

Practice location Address checks out

2921 N Center St Ste 8-9
Maryville, IL 62062
Phone: (618) 288-7804
Fax: (618) 288-7918
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X (IL)

Record details

NPI number1639405731
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amanda Henderson — Accounts Payable · (618) 288-6201
NPI enumeratedOctober 23, 2009
Last updated in NPPESOctober 8, 2012
Mailing address26 Ginger Creek Pkwy, Po Box 430, Glen Carbon, IL 62034-3502

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