COLLINSVILLE PEDIATRIC DENTISTRY PLLC is a pediatric dentistry dentist in Collinsville, IL. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. COLLINSVILLE PEDIATRIC DENTISTRY PLLC NPI is 1295366896. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
90 CRESTMOOR ST
COLLINSVILLE, IL
ZIP 62234-951
Phone: (618) 346-8000
The provider's authorized official is Corey Hastings .
The authorized official title is Owner/dentist and has the following contact phone number (618) 346-8000.
The CLIA number assigned to this NPI record is 14D0992337 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 2/1/2020 and was last updated on 2/1/2020.