| NPI | 1467977462 | 
|---|---|
| Doing Business As | PALMETTO COAST DENTAL | 
| Entity Type | Organization | 
| Authorized Contact | JESSICA BRITT Credentialing Coordinator 217-540-8426  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Enumeration Date | 2017-08-10 | 
| Last Update Date | 2022-07-21 |