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Organization
RESTORATION DENTAL LLC - CHARLESTON FAMILY DENTAL
Active
Organization
RESTORATION DENTAL LLC - CHARLESTON FAMILY DENTAL
Active
Other names
Charleston Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE VILK (OPERATIONS MANAGER)
(217) 348-7770
Entity
Organization
Contact information
Practice address
903 18TH ST, CHARLESTON, IL 61920-2938
(217) 348-7770
(217) 348-9279
Mailing address
903 18TH ST., CHARLESTON, IL 61920
(217) 348-7770
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/16/2012
Last updated
10/01/2015
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