Organization
MATT VANDERMOLEN DDS PC
Active
Other names
Advanced Dental Care of Springfield
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATT G VANDERMOLEN DDS (PRESIDENT)
(217) 546-3333
Entity
Organization
Contact information
Practice address
4701 WABASH AVE, SPRINGFIELD, IL 62711-9694
(217) 546-3333
(217) 546-1110
Mailing address
4701 WABASH AVE, SPRINGFIELD, IL 62711-9694
(217) 546-3333
(217) 546-1110
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019019785
IL
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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