| NPI | 1144033853 |
|---|---|
| Doing Business As | DENTAL CARE AT WELLEN PARK |
| Entity Type | Organization |
| Authorized Contact | JULI RENEE MIETZNER Credentialing Manager 217-540-2100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-01-28 |
| Last Update Date | 2025-01-28 |