Organization · Type 2 NPI

Southern Illinois University Carbondale

Dental Clinic/Center · Carbondale, IL

NPI number 1962674788 Active

Practice location

1365 Douglas Drive
Carbondale, IL 62901

Specialties and licenses

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000X019024395 (IL)

Dental Clinic/Center: Definition to come...

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About NPI 1962674788

Southern Illinois University Carbondale's National Provider Identifier is 1962674788, issued on Apr 1, 2008. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Carbondale, IL. The record was last updated on Sep 24, 2021.