Organization
BELTLINE DENTAL
Active
Other names
Beltline Dental
Organization subpart
No
Provider details
NPI number
Authorized official
EMILEE CLARK (CREDENTIALING MANAGER)
(618) 207-3405
Entity
Organization
Contact information
Practice address
3601 N BELT W, BELLEVILLE, IL 62226
(618) 235-9101
(618) 235-9101
Mailing address
1922 EDWARDSVILLE CLUB PLAZA, EDWARDSVILLE, IL 62025
(618) 207-3405
(618) 207-3405
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019025281
IL
Other
Enumeration date
07/05/2012
Last updated
03/24/2025
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