NPI | 1154803252 |
---|---|
Doing Business As | ASPEN VIEW DENTAL |
Entity Type | Organization |
Authorized Contact | CASSANDRA PETERSEN Credentialing Team Lead 217-540-8972 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2018-09-05 |
Last Update Date | 2018-09-05 |