Organization
BELLWOOD FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN SONES (OWNER)
(618) 656-0608
Entity
Organization
Contact information
Practice address
160 S BELLWOOD DR STE A, EAST ALTON, IL 62024-2086
(618) 258-0239
(618) 258-0765
Mailing address
160 S BELLWOOD DR STE A, EAST ALTON, IL 62024-2086
(618) 258-0239
(618) 258-0765
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019028342
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134961758
NPI
IL
01
—
1306576996
NPI
IL
01
—
1588344824
NPI
IL
01
—
16394997991
NPI
IL
01
—
1881262434
NPI
IL
01
—
1982221313
NPI
IL
Enumeration date
05/16/2018
Last updated
08/20/2024
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