Duquoin Dental Associates, Ltd.
Clinic/Center, Dental in Du Quoin, IL. Organization (NPI-2).
NPI number1043480098
StatusActive
Last updated in NPPESMar 5, 2008
Details
- NPI
- 1043480098
- Entity type
- Organization (NPI-2)
- Legal business name
- Duquoin Dental Associates, Ltd.
- Organization subpart
- No
- Enumeration date
- Mar 5, 2008
- Last updated
- Mar 5, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 019027359 | IL | Yes |
Practice location
1226 S Washington StDu Quoin, IL 62832-3853
Phone 618-542-8832 · Fax 618-542-9255
Mailing address
1226 S Washington StPo Box 330
Du Quoin, IL 62832-3853
Phone 618-542-8832 · Fax 618-542-9255
Authorized official
Isaac E Davison
President/Owner
6185425889
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