| NPI | 1023757754 |
|---|---|
| Doing Business As | 9TH AVENUE DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | COURTNEY MONTEITH Credentialing Coordinator 217-540-8306 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-06-01 |