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Brian Back, D.M.D
NPI 1053565218 · on the registry since 2008 · sole proprietor
Practice
- Address
- 104 E Main St
Mascoutah, IL 62258 - Phone
- (618) 566-7384
- Fax
- (618) 566-4290
- Organisation at this address
- Taube Family Dental
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- General Practice Dentistry
1223G0001X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-06-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois