Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Maryville Family Dental

Organization Dentist · NPI 1639405731

Maryville Family Dental provides Dentist services in Maryville, Illinois. Licensed in Illinois. Registered with an NPI since 2009.

Licensed in
IL
In the registry since
2009

Practice location Address checks out

2921 N Center St Ste 8-9
Maryville, IL 62062 Not confirmed with CMS for 14 years — call before visiting
Phone: (618) 288-7804
Fax: (618) 288-7918
Show map & directions

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X (IL)

Record details

NPI number1639405731
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amanda Henderson — Accounts Payable · (618) 288-6201
NPI enumeratedOctober 23, 2009
Last updated in NPPESOctober 8, 2012
Mailing address26 Ginger Creek Pkwy, Po Box 430, Glen Carbon, IL 62034-3502

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