Organization
THE DENTAL STUDIO OF SOUTHERN ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTANY GILBRETH (CO-OWNER)
(618) 304-0998
Entity
Organization
Contact information
Practice address
741 W STATE ST STE 1, O FALLON, IL 62269-1971
(618) 632-2282
Mailing address
741 W STATE ST STE 1, O FALLON, IL 62269-1971
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/15/2022
Last updated
05/01/2022
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