OrganizationActive
Bi-State Oral and Facial Surgery, LLC
NPI 1669824439 · Oral and Maxillofacial Surgery (Dentist) · Alton, IL
Provider details
- NPI number
- 1669824439
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Authorized official
- Benjamin Schlott, Single Member
- License
- 021002736 (IL)
Practice location
3555 College Ave
Alton, IL 62002-5009
Phone: (618) 462-1646
Fax: (618) 462-5721
Mailing address
3555 College Ave
Alton, IL 62002-5009
Registry dates
- Enumerated
- 2016-07-06
- Last updated
- 2022-10-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.