NPI | 1114175940 |
---|---|
Doing Business As | FAMILY DENTISTRY OF WOODSTOCK |
Entity Type | Organization |
Authorized Contact | ROBERT EUGENE HARADEN President 815-338-0690 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2008-09-04 |
Last Update Date | 2008-09-04 |