Southern Illinois University Carbondale
Southern Illinois University Carbondale is a Dental Clinic/Center in Carbondale, Illinois. Licensed in Illinois. Registered with an NPI since 2008.
- Licensed in
- IL
- In the registry since
- 2008
Practice location Address checks out
1365 Douglas DrCarbondale, IL 62901
Phone: (618) 453-2353
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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 019024395 (IL) |
|---|
Record details
| NPI number | 1962674788 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Southern Illinois University Carbondale |
| Authorized official | Lauren Cripps — Dentist · (618) 453-2353 |
| Other names | Community Dental Center |
| NPI enumerated | April 1, 2008 |
| Last updated in NPPES | September 24, 2021 |
| Certification date | September 24, 2021 |
| Mailing address | 1365 Douglas Drive, Carbondale, IL 62901 |
Other providers in Carbondale
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Southern Illinois University Carbondale
1365 Douglas Dr College Of Applied Sciences/school Of Allied Health, Carbondale, IL 62901-6615 · (618) 453-7241