| NPI | 1104634179 |
|---|---|
| Doing Business As | DENTAL CARE AT JORDAN RANCH |
| Entity Type | Organization |
| Authorized Contact | CEMYIRA MCDOUGAL Credentialing' Coordinator 217-764-8609 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-12-23 |
| Last Update Date | 2024-12-23 |