MEDICARE: TROY DENTAL ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1801758446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TROY DENTAL ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	21 GLEN ED PROFESSIONAL PARK
Second Line	:
City	:	GLEN CARBON
State	:	IL
Zip	:	62034-3333
Country	:	US
Telephone Number	:	618-656-0608
Fax Number	:	618-656-0615

Provider Business Practice Location Address
First Line	:	500 EDWARDSVILLE ROAD
Second Line	:
City	:	TROY
State	:	IL
Zip	:	62294
Country	:	US
Telephone Number	:	618-656-0608
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JON SONES
Credential	:	DMD
Telephone Number	:	618-420-3825

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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Directions to “TROY DENTAL ASSOCIATES LLC ” Practice Location

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