Individual
KATELYN CECELIA GENENBACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
101 UNITED DR STE 150, COLLINSVILLE, IL 62234-7439
(618) 345-7676
Mailing address
2330 S 48TH ST, QUINCY, IL 62305-6097
(217) 617-6794
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019032754
IL
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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