NPI | 1316485477 |
---|---|
Doing Business As | CENTER FOR EXCEPTIONAL DENTISTRY |
Entity Type | Organization |
Authorized Contact | CASSANDRA TEUTSCH Credentialing Coordinator 217-540-8972 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2017-02-08 |
Last Update Date | 2017-02-08 |