NPI | 1477009520 |
---|---|
Doing Business As | GULF SHORE COSMETIC AND FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | CASSANDRA TEUTSCH Credentialing Coordinator 217-540-8972 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2016-08-29 |
Last Update Date | 2016-08-29 |