NPI | 1457742272 |
---|---|
Doing Business As | PAVILION CROSSING DENTAL CARE |
Entity Type | Organization |
Authorized Contact | KENDRA WALKER Credentialing Coordinator 217-540-8312 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN18222) |
Enumeration Date | 2015-02-16 |
Last Update Date | 2015-02-20 |