NPI | 1053731828 |
---|---|
Doing Business As | MYDENTIST-MERIDIAN ORAL SURGERY |
Entity Type | Organization |
Authorized Contact | HANNAH FISH Credentialing Coordinator 217-540-5699 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Enumeration Date | 2014-04-21 |
Last Update Date | 2016-04-27 |