NPI | 1093305930 |
---|---|
Doing Business As | UPTOWN DENTAL |
Entity Type | Organization |
Authorized Contact | TABATHA LEMKE Credentialing Coordinator 217-540-6078 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2021-01-25 |
Last Update Date | 2021-01-25 |