| NPI | 1306192273 |
|---|---|
| Doing Business As | CENTER FOR COSMETIC & FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CARMEN WOODS Credentialing Manager 217-540-5141 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2022-09-26 |