Organization
ORAL SURGEONS OF SOUTHERN ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE ALLEN SCHUTTE D.D.S. (PRESIDENT)
(618) 628-1800
Entity
Organization
Contact information
Practice address
741 W STATE ST, SUITE 3, O FALLON, IL 62269-1971
(618) 628-1800
(618) 628-3406
Mailing address
741 W STATE ST, SUITE 3, O FALLON, IL 62269-1971
(618) 628-1800
(618) 628-3406
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021.001638
IL
Other
Enumeration date
12/11/2006
Last updated
08/16/2013
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