Southern Illinois University Carbondale in Carbondale - Dental
Southern Illinois University Carbondale - NPI 1962674788
Southern Illinois University Carbondale is a Dental in Carbondale, Illinois. Southern Illinois University Carbondale practices all healthcare services and medical treatments related to Dental. The NPI Number for Southern Illinois University Carbondale is 1962674788. The last update date is 2021-09-24.
Southern Illinois University Carbondale's current location address is 1365 Douglas Drive, Carbondale, Illinois. You can contact this provider via phone number 6184532353. The mailing address for Southern Illinois University Carbondale is 1365 Douglas Drive, Carbondale, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Southern Illinois University Carbondale |
|---|---|
| Address | 1365 Douglas Drive, Carbondale, Illinois |
| Phone Number | 6184532353 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DENTIST |
|---|---|
| Authorized Official Name | Cripps Lauren |
| Credentials | DMD |
| Telephone Number | 6184532353 |
NPI Number Detail
| NPI Number | 1962674788 |
|---|---|
| Provider Enumeration Date | 2008-04-01 |
| Last Updated Date | 2021-09-24 |
Provider Mailing Address Detail
| Address | 1365 Douglas Drive |
|---|---|
| City | Carbondale |
| State | Illinois (IL) |
| Post Code | 62901 |
| Phone Number | 6184532353 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
| Licence No | 19024395 |
|
Definition: Provides general and specialized dental care and oral surgery. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1184615866 | IL | -- | |
| 19.032439 | IL | -- | |
| 1295716959 | IL | -- | |
| 1023008364 | IL | -- |
Post Comment/ Review Below
What is the Southern Illinois University Carbondale's 1962674788?
The Southern Illinois University Carbondale's NPI (National Provider Identifier) Number is 1962674788. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Southern Illinois University Carbondale is geographically located?
The Southern Illinois University Carbondale is physically situated at the following location: 1365 Douglas Drive, Carbondale, IL, 62901.
What is Southern Illinois University Carbondale's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Southern Illinois University Carbondale is Dental, and the taxonomy code that classifies this field of practice is 261Qd0000X.
On what date did the Southern Illinois University Carbondale receive its 1962674788 assignment from the Centers for Medicare & Medicaid Services?
The Southern Illinois University Carbondale was assigned its 1962674788 by the Centers for Medicare & Medicaid Services on 2008-04-01.
As of what date was the information regarding Southern Illinois University Carbondale, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Southern Illinois University Carbondale, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2021-09-24.
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