Southern Illinois University Carbondale Dental Sealant Program
Southern Illinois University Carbondale Dental Sealant Program is a Public Health Dentistry in Carbondale, Illinois. Registered with an NPI since 2008.
- In the registry since
- 2008
- Specialties on file
- 2
Practice location Address checks out
1365 Douglas Dr Rm 18 Casa Sah MC 6615Carbondale, IL 62901-2583
Phone: (618) 453-7211
Fax: (618) 453-7020
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Public Health Dentistry (primary) | Taxonomy 1223D0001X |
|---|---|
| Dental Clinic/Center | Taxonomy 261QD0000X |
Record details
| NPI number | 1053582189 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Southern Illinois University Carbondale |
| Authorized official | Jennifer Kreid — Dsgp Program Coordinator · (618) 453-8823 |
| Other names | Childrens Healthcare Found Grant |
| NPI enumerated | March 17, 2008 |
| Last updated in NPPES | June 3, 2025 |
| Certification date | June 3, 2025 |
| Mailing address | 1365 Douglas Dr Rm 18, Casa, Sah, Mc 6615, Carbondale, IL 62901-2583 |
Other providers in Carbondale
-
Smichael Vancil DMD LLC
1255 Cedar Ct, Carbondale, IL 62901-5335 · (618) 529-3931