Individual
DR. ERIC JEFFREY KUBACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2800 COLLEGE AVE, ALTON, IL 62002-4742
(618) 474-7000
Mailing address
1214 OAKLEAF DR, SAINT LOUIS, MO 63119-1038
(815) 531-2746
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019033726
IL
Other
Enumeration date
08/30/2023
Last updated
09/24/2024
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