| NPI | 1255738787 |
|---|---|
| Doing Business As | TRACY ORCHARD DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | LINDSAY BEARDEN Credentialing Coordinator 217-540-5699 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2014-11-26 |