| NPI | 1447645726 |
|---|---|
| Doing Business As | ALEGRE DENTAL @ BOSQUE |
| Entity Type | Organization |
| Authorized Contact | KIM WILSON Cred Superivsor 217-540-5170 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2015-04-02 |