| NPI | 1235960055 |
|---|---|
| Doing Business As | OAK GROVE DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | HILLARY THULL Credentialing Coordinator 217-540-8946 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2024-08-13 |