| NPI | 1144068602 | 
|---|---|
| Doing Business As | LAKE JULIANA DENTAL CARE | 
| Entity Type | Organization | 
| Authorized Contact | CEMYIRA MCDOUGAL Credentialing Coordinator 217-764-8609  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Enumeration Date | 2024-07-18 | 
| Last Update Date | 2024-07-18 |