Individual
JEFFREY MINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6294 STATE HIGHWAY 154, SESSER, IL 62884-2163
(618) 625-6979
(618) 625-5362
Mailing address
PO BOX 155, REA CLINIC, CHRISTOPHER, IL 62822
(618) 724-2401
(618) 724-2571
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1002990
IL
Other
Enumeration date
01/02/2007
Last updated
08/10/2011
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