Organization
CENTRAL ILLINOIS ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY KROEGER (INSURANCE COORDINATOR)
(217) 540-5100
Entity
Organization
Contact information
Practice address
1200 NETWORK CENTRE DR STE A, EFFINGHAM, IL 62401-4637
(217) 540-5100
(877) 635-3298
Mailing address
1200 NETWORK CENTRE DR STE A, EFFINGHAM, IL 62401-4637
(217) 540-5100
(877) 635-3298
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
06/11/2008
Last updated
11/12/2008
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