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Organization
SOUTHERN IL DENTAL SLEEP MEDICINE
Active
Organization
SOUTHERN IL DENTAL SLEEP MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL R DURR DMD (OWNER)
(618) 529-2471
Entity
Organization
Contact information
Practice address
864 KOONCE RD, MURPHYSBORO, IL 62966-6048
(618) 529-2471
(618) 529-2482
Mailing address
864 KOONCE RD, MURPHYSBORO, IL 62966-6048
(618) 529-2471
(618) 529-2482
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
060.011093
IL
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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