| NPI | 1437601283 |
|---|---|
| Doing Business As | TROY FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | RICHARD R BOATMAN Manager 618-667-8070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 19-020938) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 19-025636) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |