Provider Demographics
NPI:1750794970
Name:EVERYONE'S FAMILY DENTAL ST. CHARLES
Entity type:Organization
Organization Name:EVERYONE'S FAMILY DENTAL ST. CHARLES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUBRAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:217-431-4990
Mailing Address - Street 1:909 N LOGAN AVE
Mailing Address - Street 2:217-431-4990
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-3742
Mailing Address - Country:US
Mailing Address - Phone:217-431-4990
Mailing Address - Fax:
Practice Address - Street 1:909 N LOGAN AVE
Practice Address - Street 2:217-431-4990
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-3742
Practice Address - Country:US
Practice Address - Phone:217-431-4990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028603122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty