| NPI | 1164775029 |
|---|---|
| Doing Business As | WEST FALLS CHURCH DENTAL |
| Entity Type | Organization |
| Authorized Contact | CARMEN WOODS Insurance/Credentialing 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2014-01-11 |