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Organization
RONALD WEEMS JR. P.C.
Active
Organization
RONALD WEEMS JR. P.C.
Active
Other names
Shiloh Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA HENDERSON JR. (OWNER)
(618) 288-6201
Entity
Organization
Contact information
Practice address
3750 GREEN MOUNT CROSSING DR, O FALLON, IL 62269-7293
(618) 628-7050
(618) 628-6957
Mailing address
26 GINGER CREEK PKWY, PO BOX 430, GLEN CARBON, IL 62034-3502
(618) 288-6201
(618) 288-6452
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019025159
IL
Other
Enumeration date
03/17/2010
Last updated
05/14/2013
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