Provider Demographics
NPI:1184009615
Name:SANTEL, KASEY (DMD)
Entity Type:Individual
Prefix:DR
First Name:KASEY
Middle Name:
Last Name:SANTEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BREESE
Mailing Address - State:IL
Mailing Address - Zip Code:62230-1629
Mailing Address - Country:US
Mailing Address - Phone:618-526-2020
Mailing Address - Fax:618-526-8330
Practice Address - Street 1:111 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BREESE
Practice Address - State:IL
Practice Address - Zip Code:62230-1629
Practice Address - Country:US
Practice Address - Phone:618-526-2020
Practice Address - Fax:618-526-8330
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0303351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice