| NPI | 1134549132 |
|---|---|
| Doing Business As | DENTAL CARE OF FAYETTEVILLE |
| Entity Type | Organization |
| Authorized Contact | HANNAH BEAR Credentialing COO Rdinator 217-540-5699 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2016-09-02 |