| NPI | 1417377177 | 
|---|---|
| Doing Business As | FAMILIA DENTAL | 
| Entity Type | Organization | 
| Authorized Contact | BRANDON ALEXANDER TAYLOR Credentialing & Payer Relations Man 847-453-7396 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental | 
| Additional Taxonomies | 122300000X Dentist | 
| Enumeration Date | 2014-04-21 | 
| Last Update Date | 2021-10-15 |