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Organization
SOUTHERN ILLINOIS FAMILY DENTISTRY LLC
Active
Organization
SOUTHERN ILLINOIS FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY RUBENACKER (DENTIST)
(618) 841-6431
Entity
Organization
Contact information
Practice address
1030 4TH ST, ELDORADO, IL 62930-1702
(618) 273-9361
Mailing address
7754 STATE ROUTE 14, MC LEANSBORO, IL 62859-4501
(618) 841-6431
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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