| NPI | 1104532332 |
|---|---|
| Doing Business As | COMMUNITY DENTAL |
| Entity Type | Organization |
| Authorized Contact | STARLA CUMMINGS CFO 270-365-0227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2023-01-31 |