NPI | 1376222117 |
---|---|
Doing Business As | DREAM TEAM DENTISTRY AND ASSOCIATES, PLLC |
Entity Type | Organization |
Authorized Contact | COURTNEY R MONTEITH Credentialing Coordinator 217-540-8306 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2023-07-17 |
Last Update Date | 2023-07-24 |