Individual provider · Type 1 NPI

Samuel Lee Donavon, DMD

Dentist · Glen Carbon, IL

NPI number 1164357737 Active

Practice location

21 Glen Ed Professional Park
Glen Carbon, IL 62034-3333

Fax (618) 656-0615

Specialties and licenses

Taxonomy	Code	License
Dentist Primary	122300000X	01903713 (IL)

Dentist: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requiremen…

7 other providers at this address

Other dentist providers in Glen Carbon

See all in Glen Carbon →

About NPI 1164357737

Samuel Lee Donavon, DMD's National Provider Identifier is 1164357737, issued on Jun 16, 2026. The primary taxonomy on file is Dentist (122300000X), and the practice location is in Glen Carbon, IL. The record was last updated on Jun 16, 2026.