| NPI | 1003233107 |
|---|---|
| Doing Business As | FAMILY DENTAL OF CANTON |
| Entity Type | Organization |
| Authorized Contact | JEAN CORNELL Credentialing Coordinator 217-540-8329 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2014-03-26 |