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Organization
SHILOH DENTAL GROUP LLC
Active
Organization
SHILOH DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GUILBEAULT (OWNER/DENTIST)
(618) 643-9523
Entity
Organization
Contact information
Practice address
301 TAMARACK LN, SHILOH, IL 62269-2993
(618) 643-9523
Mailing address
1922 EDWARDSVILLE CLUB PLAZA CT, EDWARDSVILLE, IL 62025-3717
(618) 643-9523
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/25/2015
Last updated
01/22/2016
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