| NPI | 1023313533 |
|---|---|
| Doing Business As | PADDOCK PLACE DENTAL |
| Entity Type | Organization |
| Authorized Contact | KAM SHICK Insurance Coordinator 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2014-09-17 |