Organization
GINGER CREEK DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GUILBEAULT D.M.D. (DENTIST)
(618) 692-1110
Entity
Organization
Contact information
Practice address
24 GINGER CREEK PKWY, GLEN CARBON, IL 62034-3502
(618) 692-1110
Mailing address
24 GINGER CREEK PKWY, GLEN CARBON, IL 62034-3502
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019025281
IL
Other
Enumeration date
08/09/2010
Last updated
08/09/2010
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