| NPI | 1427394733 |
|---|---|
| Doing Business As | NORTH SIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | MARIE KUHL Credentialing Manager 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2012-12-14 |
| Last Update Date | 2012-12-14 |