Organization
JILL KINSELLA DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL ANNE KINSELLA DMD (OWNER/DENTIST)
(618) 744-1969
Entity
Organization
Contact information
Practice address
703 SEIBERT RD., SUITE 5, SCOTT AFB, IL 62225
(618) 744-1969
(618) 744-1986
Mailing address
703 SEIBERT RD., SUITE 5, SCOTT AFB, IL 62225
(618) 744-1969
(618) 744-1986
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027404
IL
Other
Enumeration date
12/29/2011
Last updated
06/21/2018
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