| NPI | 1447621669 |
|---|---|
| Doing Business As | CHESTNUT HILLS DENTAL MCCANDLESS COVENANT |
| Entity Type | Organization |
| Authorized Contact | CELIA HAYES Credentialing Coordinator 217-540-2100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: PA DS029676) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2022-04-18 |