Organization
JEANINE HUDDLESTUN-JOHNS D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEANINE MARIE HUDDLESTUN-JOHNS D.D.S. (OWNER)
(618) 783-3714
Entity
Organization
Contact information
Practice address
605 SOUTH VANBUREN, NEWTON, IL 62448
(618) 783-3714
(618) 783-3294
Mailing address
605 SOUTH VANBUREN, NEWTON, IL 62448
(618) 783-3714
(618) 783-3294
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101119
—
IL
05
—
180942
—
IL
Enumeration date
03/10/2008
Last updated
03/10/2008
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