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Organization
WEST END FAMILY DENTAL
Active
Organization
WEST END FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GUILBEAULT (OWNER)
(618) 692-1110
Entity
Organization
Contact information
Practice address
24 GINGER CREEK PKWY, GLEN CARBON, IL 62034-3502
(618) 692-1110
Mailing address
6911 W MAIN ST, BELLEVILLE, IL 62223-3029
(618) 397-5000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019025281
IL
Other
Enumeration date
11/15/2013
Last updated
11/15/2013
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