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Organization

MIDWEST FAMILY DENTISTRY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LANEY ELAYNE SCHUMAN-BOYS DMD (PRESIDENT)
(618) 797-9940
Entity
Organization

Contact information

Practice address
3120 MARYVILLE RD, GRANITE CITY, IL 62040-5119
(618) 797-9940
Mailing address
3120 MARYVILLE RD, GRANITE CITY, IL 62040-5119
(618) 797-9940

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-023663
IL
332BC3200X
Customized Equipment (DME)

Other

Enumeration date
04/07/2007
Last updated
08/11/2015
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