Individual
DR. BENJAMIN JACOB SCHLOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D , M.D.
Contact information
Practice address
3555 COLLEGE AVE, ALTON, IL 62002-5009
(618) 462-1646
(618) 462-5211
Mailing address
3555 COLLEGE AVE, ALTON, IL 62002-5009
(618) 462-1646
(618) 462-5211
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DTP602
FL
1223G0001X
General Practice Dentistry
019026421
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021002736
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2011013340
MO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DTP602
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
036140395
IL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
2011022969
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891938296
—
MO
Enumeration date
04/14/2009
Last updated
12/02/2021
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