# ORAL SURGEONS OF SOUTHERN ILLINOIS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477613297
- **Authorized official:** DR. DALE ALLEN SCHUTTE D.D.S. (PRESIDENT)
- **Authorized official phone:** (618) 628-1800

## Contact information

- **Practice address:** 741 W STATE ST, SUITE 3, O FALLON, IL 62269-1971
- **Practice address phone:** (618) 628-1800
- **Practice address fax:** (618) 628-3406
- **Mailing address:** 741 W STATE ST, SUITE 3, O FALLON, IL 62269-1971
- **Mailing address phone:** (618) 628-1800
- **Mailing address fax:** (618) 628-3406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 021.001638 | IL | Yes |

## Other

- **Enumeration date:** 12/11/2006
- **Last updated:** 08/16/2013