NPI | 1124726922 |
---|---|
Doing Business As | DENTAL CARE OF HERITAGE LAKES |
Entity Type | Organization |
Authorized Contact | HILLARY THULL Credentialing Coordinator 217-540-8946 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2023-02-21 |
Last Update Date | 2023-02-21 |