NPI | 1013328962 |
---|---|
Doing Business As | RED ROSE FAMILY DENTAL |
Entity Type | Organization |
Authorized Contact | KENDRA WALKER Credentialing Supervisor 217-540-8312 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2014-05-14 |
Last Update Date | 2017-06-05 |