NPI | 1003578097 |
---|---|
Doing Business As | SMITH CROSSING DENTAL CARE |
Entity Type | Organization |
Authorized Contact | CELIA HAYES Credentialing COO Rdinator 217-540-2100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist General Practice |
Enumeration Date | 2021-10-07 |
Last Update Date | 2024-10-04 |