| NPI | 1285313023 |
|---|---|
| Doing Business As | SORRENTO EAST DENTAL |
| Entity Type | Organization |
| Authorized Contact | COURTNEY R MONTEITH Credentialing Coordinator 217-540-8306 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2023-07-17 |