| NPI | 1306175179 |
|---|---|
| Doing Business As | RENAISSANCE AESTHETIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | PAM HARDIEK Insurance/Credentialing 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2009-12-08 |