| NPI | 1235413451 | 
|---|---|
| Doing Business As | TREASURE COAST FAMILY DENTAL | 
| Entity Type | Organization | 
| Authorized Contact | PAM HARDIEK Insurance/Credentialing 217-540-5100  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Enumeration Date | 2011-10-06 | 
| Last Update Date | 2011-10-06 |