| NPI | 1295133791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN ZOLDESSY Dental Director 879-267-6290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: AR 2145) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2014-12-15 |