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Organization
SOUTHERN VIEW DENTAL GROUP
Active
Organization
SOUTHERN VIEW DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IBRAHIM MASSOUD DDS (OWNER)
(217) 522-4121
Entity
Organization
Contact information
Practice address
2743 S 6TH STREET, SPRINGFIELD, IL 62703
(217) 522-4121
(217) 522-7140
Mailing address
2743 S 6TH STREET, SPRINGFIELD, IL 62703
(217) 522-4121
(217) 522-7140
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/14/2006
Last updated
08/22/2020
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