Organization
MID AMERICA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE WESTRA DMD (OWNER)
(217) 549-6928
Entity
Organization
Contact information
Practice address
607 W ORCHARD ST, VANDALIA, IL 62471-1234
(618) 283-2929
Mailing address
522 E JASPER ST, PARIS, IL 61944-2437
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/02/2025
Last updated
12/02/2025
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