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Organization

SOUTHERN ILLINOIS UNIVERSITY CARBONDALE

Active
Other names
Illinois Children's Healthcare Foundation Dental Grant Project
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. RONDA DEMATTEI RDH, PHD (ASSOC. PROF./DENTAL HYGIENE PROGRAM)
(618) 453-7298
Entity
Organization

Contact information

Practice address
1365 DOUGLAS DR, COLLEGE OF APPLIED SCIENCES/SCHOOL OF ALLIED HEALTH, CARBONDALE, IL 62901-6615
(618) 453-7241
(618) 453-7020
Mailing address
1365 DOUGLAS DR, COLLEGE OF APPLIED SCIENCES/SCHOOL OF ALLIED HEALTH, CARBONDALE, IL 62901-6615
(618) 453-7241
(618) 453-7020

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
IL

Other

Enumeration date
03/27/2008
Last updated
03/27/2008
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