NPI | 1144790528 |
---|---|
Doing Business As | PROVIDENCE DENTAL CARE |
Entity Type | Organization |
Authorized Contact | TY JUSTICE Director, Payer Relations 513-808-4984 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122300000X Dentist |
Enumeration Date | 2018-11-28 |
Last Update Date | 2018-11-28 |