Organization
MATTOON DENTAL PC
Active
Parent organization
MATTOON DENTAL PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MATTOON DENTAL PC
Authorized official
DR. GREGORY G YOUNT DMD (DENTIST OWNER)
(217) 235-0434
Entity
Organization
Contact information
Practice address
225 RICHMOND AVE E, MATTOON, IL 61938
(217) 235-0434
(217) 234-3418
Mailing address
PO BOX 1217, MATTOON, IL 61938
(217) 235-0434
(217) 234-3418
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019020918
IL
Other
Enumeration date
05/16/2008
Last updated
05/16/2008
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