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
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | 019024395 (IL) |
Dental Clinic/Center: Definition to come...
Other dental clinic/center providers in Carbondale
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.