NPI | 1306107578 |
---|---|
Doing Business As | FAMILY DENTAL |
Entity Type | Organization |
Authorized Contact | BRANDON ALEXANDER TAYLOR Credentialing Payer Relations Mgr 847-453-7396 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2012-06-05 |
Last Update Date | 2021-10-15 |