| NPI | 1093004921 |
|---|---|
| Doing Business As | DENTAL CARE AT CRYSTAL PARK |
| Entity Type | Organization |
| Authorized Contact | KAM SHICK Insurance Coordinator 217-540-5141 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2022-09-26 |