NPI | 1467872325 |
---|---|
Doing Business As | WHEATLAND FAMILY DENTAL |
Entity Type | Organization |
Authorized Contact | KENDRA WALKER Credentialing Coordinator 217-540-8312 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2014-04-18 |
Last Update Date | 2015-10-27 |