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Organization
OWEN DENTAL, LLC.
Active
Organization
OWEN DENTAL, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON OWEN DMD (PRESIDENT/DENTIST)
(618) 406-0965
Entity
Organization
Contact information
Practice address
504 N MAIN ST, SMITHTON, IL 62285-1518
(618) 233-9012
(618) 233-2399
Mailing address
8808 WHEAT DR, TROY, IL 62294-2272
(618) 406-0965
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
12/11/2020
Last updated
07/29/2021
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