NPI | 1154631075 |
---|---|
Doing Business As | FDC - MAPLE LAWN |
Doing Business As | FULTON FAMILY DENTAL CARE |
Entity Type | Organization |
Authorized Contact | CARMEN WOODS Insurance/Credentialing 217-540-5100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2010-10-13 |
Last Update Date | 2021-11-06 |