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Organization
SOUTHERN ILLINOIS PEDIATRIC DENTISTRY OF EDWARDSVILLE
Active
Organization
SOUTHERN ILLINOIS PEDIATRIC DENTISTRY OF EDWARDSVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTINE ANNE WOHLFORD DMD (DENTIST/MEMBER)
(618) 655-3272
Entity
Organization
Contact information
Practice address
1419 LEWIS ROAD, SUITE 2, EDWARDSVILLE, IL 62025
(618) 655-3272
(618) 655-3273
Mailing address
1419 LEWIS ROAD, SUITE 2, EDWARDSVILLE, IL 62025
(618) 655-3272
(618) 655-3273
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
NULL
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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