Organization
ARCH VIEW FAMILY DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA MARIE YORK (PRACTICE ADMIN)
(618) 335-0430
Entity
Organization
Contact information
Practice address
2133 S STATE ROUTE 157, EDWARDSVILLE, IL 62025-3691
(618) 656-2006
(618) 656-2066
Mailing address
2133 S STATE ROUTE 157, EDWARDSVILLE, IL 62025-3691
(618) 656-2006
(618) 656-2066
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649495458
NPI
IL
01
—
1720300585
NPI
IL
01
—
19-025636
STATE OF IL DENTAL LICENSE
IL
01
—
19-028117
STATE OF IL DENTAL LICENSE
IL
Enumeration date
04/16/2019
Last updated
04/16/2019
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