NPI | 1447484571 |
---|---|
Doing Business As | BLOOMINGTON SMILE CENTER |
Entity Type | Organization |
Authorized Contact | LINDSAY BEARDEN Insurance/Credentialing 217-540-5100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2009-05-04 |
Last Update Date | 2014-01-07 |