Individual
ROXANNE WINEBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
309 TAMARACK LN, O FALLON, IL 62269-2993
(618) 624-7200
Mailing address
309 TAMARACK LN, O FALLON, IL 62269-2993
(618) 624-7200
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019032747
IL
122300000X
Dentist
2020018228
MO
Other
Enumeration date
06/30/2020
Last updated
03/10/2025
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