| NPI | 1063576031 |
|---|---|
| Doing Business As | NICHOLS PARK DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | AMY M KROEGER Ins COO D 217-540-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2020-08-22 |