Organization
KYLE R CHILDERS DMD MS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE RAY CHILDERS DMD MS (OWNER)
(618) 438-2815
Entity
Organization
Contact information
Practice address
201 W WASHINGTON ST, BENTON, IL 62812
(618) 438-2815
(618) 439-6127
Mailing address
201 W WASHINGTON ST, BENTON, IL 62812
(618) 438-2815
(618) 439-6127
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
IL
Other
Enumeration date
02/12/2007
Last updated
08/22/2020
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