Organization
JERSEYVILLE DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA LIFRITZ (DIRECTOR OF OPERATIONS/ACQUISITIONS)
(618) 873-7500
Entity
Organization
Contact information
Practice address
105 S STATE ST, JERSEYVILLE, IL 62052-1850
(618) 498-5822
(618) 498-5822
Mailing address
105 S STATE ST, JERSEYVILLE, IL 62052-1850
(618) 498-5822
(618) 498-5822
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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