Organization
SOUTHERN ILLINOIS PEDIATRIC DENTISTRY OF EDWARDSVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTINE ANNE WOHLFORD DMD (DENTIST/MEMBER)
(618) 655-3272
Entity
Organization
Contact information
Practice address
1419 LEWIS ROAD, SUITE 2, EDWARDSVILLE, IL 62025
(618) 655-3272
(618) 655-3273
Mailing address
1419 LEWIS ROAD, SUITE 2, EDWARDSVILLE, IL 62025
(618) 655-3272
(618) 655-3273
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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