Periodontics of Southern Illinois
Periodontics of Southern Illinois provides Periodontics in Belleville, Illinois. Licensed in Illinois. Registered with an NPI since 2007.
- Licensed in
- IL
- In the registry since
- 2007
- Specialties on file
- 3
Practice location Address checks out
#11 Park PlBelleville, IL 62226-2925
Phone: (618) 233-7300
Fax: (618) 233-7432
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Periodontics (primary) | Taxonomy 1223P0300X (IL) |
|---|---|
| Periodontics | Taxonomy 1223P0300X (IL) |
| Periodontics | Taxonomy 1223P0300X (IL) |
Record details
| NPI number | 1639224876 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Josepj Renner — Owner · (618) 233-7300 |
| NPI enumerated | January 25, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 11 Park Place, Belleville, IL 62226-2925 |