NPI | 1326687237 |
---|---|
Doing Business As | ENSO DENTISTRY |
Entity Type | Organization |
Authorized Contact | CEMYIRA MCDOUGAL Credentialing Coordinator 217-764-8609 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2019-12-26 |
Last Update Date | 2024-02-02 |