# STOP ELEVEN DENTAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952788762
- **Authorized official:** DAVID GUILBEAULT DDS (DENTIST/OWNER)
- **Authorized official phone:** (618) 248-2038

## Contact information

- **Practice address:** 4950 E STOP 11 RD, STE A, INDIANAPOLIS, IN 46237-9100
- **Practice address phone:** (618) 248-2038
- **Mailing address:** 1922 EDWARDSVILLE CLUB PLAZA CT, EDWARDSVILLE, IL 62025-3717

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12012272A | IN | Yes |

## Other

- **Enumeration date:** 04/30/2015
- **Last updated:** 03/11/2016