| NPI | 1144524752 |
|---|---|
| Doing Business As | MYSTONEBRIDGEDENTIST.COM |
| Entity Type | Organization |
| Authorized Contact | JENNIFER HOELSCHER Insurance/Credentialing 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2010-12-23 |
| Last Update Date | 2014-02-05 |