NPI | 1356677058 |
---|---|
Doing Business As | SHAWNEE HEALTH CARE, MARION DENTAL |
Entity Type | Organization |
Authorized Contact | CHRISTINA CARNEY CEO 618-956-9521 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 122300000X Dentist |
1223P0221X Dentist, Pediatric Dentistry | |
124Q00000X Dental Hygienist | |
126800000X Dental Assistant | |
Enumeration Date | 2009-10-30 |
Last Update Date | 2024-04-04 |