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Organization
WOOD RIVER DENTAL GROUP LLC
Active
Organization
WOOD RIVER DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GUILBEAULT DMD (OWNER/DENTIST)
(618) 248-2038
Entity
Organization
Contact information
Practice address
1075 HARRISON ST, WOOD RIVER, IL 62095-1867
(618) 259-5200
Mailing address
1922 EDWARDSVILLE CLUB PLAZA CT, EDWARDSVILLE, IL 62025-3717
(618) 248-2038
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
01/26/2015
Last updated
01/26/2015
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