Organization
GREEN MOUNT DENTAL, LLC
Active
Other names
Parkway Smile Center
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GUILBEAULT (OWNER/DENTIST)
(618) 643-9523
Entity
Organization
Contact information
Practice address
2810 FRANK SCOTT PKWY W STE 800, BELLEVILLE, IL 62223-5007
(618) 235-9696
Mailing address
1922 EDWARDSVILLE CLUB PLAZA CT, EDWARDSVILLE, IL 62025-3717
(618) 643-9523
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/17/2015
Last updated
07/21/2022
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