NPI | 1205057403 |
---|---|
Doing Business As | DENTISTRY PLUS - HICKORY HOLLOW |
Entity Type | Organization |
Authorized Contact | AMY KROEGER Ins Cood 217-540-5100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2007-05-02 |
Last Update Date | 2008-05-21 |