Organization
GERALD R. DRAGICH, D.M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD RAY DRAGICH D.M.D. (PRESIDENT)
(618) 236-0900
Entity
Organization
Contact information
Practice address
3909 N BELT W, A, BELLEVILLE, IL 62226-5607
(618) 236-0900
(618) 236-0913
Mailing address
3909 N BELT W, A, BELLEVILLE, IL 62226-5607
(618) 236-0900
(618) 236-0913
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.017181
IL
Other
Enumeration date
12/29/2011
Last updated
12/29/2011
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