NPI | 1366965428 |
---|---|
Doing Business As | WEST UNIVERSITY FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | CASSANDRA TEUTSCH Credentialing Coordinator 217-540-8972 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2017-07-20 |
Last Update Date | 2022-07-21 |