Organization
DRS SELBERG & RICE PLLC
Active
Other names
Associated Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIE FRITZ (BUSINESS ADMINISTRATOR)
(618) 622-2916
Entity
Organization
Contact information
Practice address
4945 STONE FALLS CTR STE B, O FALLON, IL 62269-7801
(618) 622-0212
Mailing address
4945 STONE FALLS CTR STE B, O FALLON, IL 62269-7801
(618) 622-0212
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/02/2019
Last updated
12/06/2021
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