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Organization

MIDAMERICA CENTER FOR DENTAL WELLNESS & AESTHETICS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK G BRUNK DMD (OWNER/PARTNER)
(618) 283-2929
Entity
Organization

Contact information

Practice address
607 W ORCHARD ST, VANDALIA, IL 62471-1234
(618) 283-2929
(618) 283-2113
Mailing address
607 W ORCHARD ST, VANDALIA, IL 62471-1234
(618) 283-2929
(618) 283-2113

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019019107
IL

Other

Enumeration date
12/17/2015
Last updated
02/09/2017
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