NPI | 1447511795 |
---|---|
Doing Business As | WOODMONT FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | PAM HARDIEK Insurance/Credentialing 217-540-5100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2012-06-04 |
Last Update Date | 2012-06-04 |