| NPI | 1043715204 |
|---|---|
| Doing Business As | PILOT KNOB DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | JESSICA BRITT Credentialing Coordinator 217-540-8426 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-06-05 |