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

Southern Illinois University Edwardsville School of Dental Medicine

Organization General Practice Dentistry · NPI 1215912696

Southern Illinois University Edwardsville School of Dental Medicine is a General Practice Dentistry in Alton, Illinois. Licensed in Illinois. Registered with an NPI since 2005.

Licensed in
IL
In the registry since
2005

Practice location Address checks out

2800 College Ave
Alton, IL 62002-4700
Phone: (618) 474-7080
Fax: (618) 474-7029
Show map & directions

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

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 19018978 (IL)

Record details

NPI number1215912696
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Debra Schwenk — Associate Dean For Clinical Affairs · (618) 474-7080
NPI enumeratedDecember 8, 2005
Last updated in NPPESJuly 10, 2007
Mailing address2800 College Ave, Alton, IL 62002-4700

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