Healthcare Provider Details

I. General information

NPI: 1407962517
Provider Name (Legal Business Name): BIRCHER FAMILY DENTAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 N MAIN ST
SMITHTON IL
62285
US

IV. Provider business mailing address

504 N MAIN ST BOX 336
SMITHTON IL
62285
US

V. Phone/Fax

Practice location:
  • Phone: 618-233-9012
  • Fax:
Mailing address:
  • Phone: 618-233-9012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS GREGORY BIRCHER
Title or Position: OWNER
Credential: DMD
Phone: 618-233-9012