Organization
SHAWNEE HILLS ORAL & MAXILLOFACIAL SURGERY, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN W. BURTON D.M.D. (PRESIDENT)
(618) 519-9363
Entity
Organization
Contact information
Practice address
2250 N REED STATION RD, SUITE 201, CARBONDALE, IL 62901-8101
(618) 519-9363
(618) 519-9364
Mailing address
2250 N REED STATION RD, SUITE 201, CARBONDALE, IL 62901-8101
(618) 519-9363
(618) 519-9364
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
05/19/2009
Last updated
05/19/2009
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