Organization
EFFINGHAM FAMILY DENTAL LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY ROGER STEVENSON DDS (DENTIST)
(217) 342-3850
Entity
Organization
Contact information
Practice address
310 W JEFFERSON AVE, EFFINGHAM, IL 62401-2348
(217) 342-3850
(217) 342-3891
Mailing address
310 W JEFFERSON AVE, EFFINGHAM, IL 62401-2348
(217) 342-3850
(217) 342-3891
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019023431
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437378098
—
IL
Enumeration date
01/18/2017
Last updated
01/18/2017
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