NPI | 1467872374 |
---|---|
Doing Business As | DENTAL CARE OF EDMOND |
Entity Type | Organization |
Authorized Contact | HANNAH FISH Credentialing Coordinator 217-540-5699 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2014-04-17 |
Last Update Date | 2018-08-06 |