| NPI | 1194910661 |
|---|---|
| Doing Business As | LIFETIME FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | AMY KROEGER Ins Coordinator 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2007-09-07 |