Southern Illinois University Edwardsville School of Dental Medicine
Southern Illinois University Edwardsville School of Dental Medicine is a Dentist in E St Louis, Illinois. Licensed in Illinois. Registered with an NPI since 2005.
- Licensed in
- IL
- In the registry since
- 2005
Practice location Address checks out
411 E BroadwayE St Louis, IL 62201-2904
Phone: (618) 682-8318
Fax: (618) 474-7029
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dentist (primary) | Taxonomy 122300000X · Licence 19018978 (IL) |
|---|
Record details
| NPI number | 1760467146 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Dennis Savoca — Associate Dean For Clinical Affairs · (618) 474-7090 |
| NPI enumerated | December 8, 2005 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 2800 College Ave, Alton, IL 62002-4700 |