NPI | 1053865972 |
---|---|
Doing Business As | RICE CREEK FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | HEATHER PRUEMER Credentialing Team Lead 217-540-8434 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2016-08-09 |
Last Update Date | 2016-08-09 |