NPI | 1073225918 |
---|---|
Doing Business As | SOUTH CHARLOTTE FAMILY & COSMETIC DENTISTRY |
Entity Type | Organization |
Authorized Contact | HILLARY THULL Credentialing Coordinator 217-540-8946 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2022-12-22 |
Last Update Date | 2024-10-04 |