Individual
MEGAN LYNETTE PREVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
6000 BOND AVE, DENTAL CLINIC, CENTREVILLE, IL 62207-2328
(618) 332-2740
Mailing address
6000 BOND AVE, DENTAL CLINIC, CENTREVILLE, IL 62207-2328
(618) 332-2740
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019029730
IL
122300000X
Dentist
DD3187
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/15/2008
Last updated
04/17/2015
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