Individual
KENT D. MCCONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1002 SPOTSYLVANIA ST, NEW ATHENS, IL 62264-1597
(618) 475-9989
Mailing address
1002 SPOTSYLVANIA ST, NEW ATHENS, IL 62264-1597
(618) 475-9989
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-023730
IL
Other
Enumeration date
09/05/2008
Last updated
09/05/2008
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