NPI | 1093578718 |
---|---|
Doing Business As | PALM CREEK DENTAL CARE |
Entity Type | Organization |
Authorized Contact | CEMYIRA MCDOUGAL Credentialing 217-764-8609 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2024-02-05 |
Last Update Date | 2024-02-05 |