NPI | 1053154393 |
---|---|
Doing Business As | DENTAL CARE AT AUTUMN RUN |
Entity Type | Organization |
Authorized Contact | HILLARY THULL Credentialing Coordinator 217-540-8946 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2024-06-14 |
Last Update Date | 2024-06-14 |