Chester Smile Center
Organization Active NPI General Practice Dentistry · Chester, IL
NPI 1346552247 · NPPES record last updated Jul 8, 2010
Key facts
- NPI
- 1346552247
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 019022619 (IL)
- Legal business name
- CHESTER SMILE CENTER
- Practice address
- 1101 Opdyke St
Chester, IL 62233-2004 - Phone
- (618) 826-4440
- Fax
- (618) 826-5799
- NPI assigned
- Jul 8, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Michael Peter Holub, D.D.S.
- Title
- Doctor
- Phone
- (618) 826-4440
National Provider Directory
Locations
1101 Opdyke St
Chester, IL 62233
Phone (618) 282-6233
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 019022619 | IL | Yes |
Addresses
Primary practice location
1101 Opdyke St
Chester, IL 62233-2004
Mailing address
1101 Opdyke St
Chester, IL 62233-2004
Phone (618) 826-4440
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1002247 | Medicaid | IL |
Other providers in Chester, IL
- Chester Family Dental PLLC
- Chester Medical Group LLC
- Chester Medical Group, LLC
- Chester Mental Health Center
- Chester Rehabilitation and Nursing Center, LLC
- Renee Cissell
- Douglas Scott Cockrell
- Comwell
- Comwell
- Comwell
All providers in Chester, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.