NPI | 1013312941 |
---|---|
Doing Business As | LEBANON DENTAL CARE |
Entity Type | Organization |
Authorized Contact | ALLISON VARNER Credentialing Coordinator 217-540-6077 |
Organization Subpart ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: TN 9923) |
Enumeration Date | 2014-11-04 |
Last Update Date | 2014-11-04 |