| NPI | 1194474593 |
|---|---|
| Doing Business As | METRO DENTALCARE ST. PAUL MIDWAY - PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | CELIA HAYES Credentialing Coordinator 217-540-2100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2022-03-22 |