SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE SCHOOL OF DENTAL MEDICINE is a general practice dentist in Alton, IL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE SCHOOL OF DENTAL MEDICINE NPI is 1215912696. The provider is registered as an organization entity type and is a multi-specialty group.
The provider's business location address is:
2800 COLLEGE AVE
ALTON, IL
ZIP 62002-700
Phone: (618) 474-7080
Fax: (618) 474-7029
The provider's authorized official is Debra M Schwenk .
The authorized official title is Associate Dean For Clinical Affairs and has the following contact phone number (618) 474-7080.
The CLIA number assigned to this NPI record is 14D2188836 - school/student health service with a certificate type of Certificate of Registration.
The enumeration date for this NPI number is 12/8/2005 and was last updated on 7/10/2007.