Pinckneyville Dental Care
Clinic/Center, Dental in Pinckneyville, IL. Organization (NPI-2).
NPI number1104939735
StatusActive
Last updated in NPPESJul 30, 2014
Details
- NPI
- 1104939735
- Entity type
- Organization (NPI-2)
- Legal business name
- Pinckneyville Dental Care
- Organization subpart
- No
- Enumeration date
- Aug 17, 2006
- Last updated
- Jul 30, 2014
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 19020196 | IL | Yes |
Practice location
1000 S Main StPinckneyville, IL 62274-1772
Phone 618-357-2445 · Fax 618-357-9549
Mailing address
Po Box 469Pinckneyville, IL 62274-0469
Phone 618-357-2445 · Fax 618-357-9549
Authorized official
Ralph Kane Chapman
Owner
6183572445
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