NPI | 1487294351 |
---|---|
Doing Business As | PALOS FAMILY DENTAL |
Entity Type | Organization |
Authorized Contact | ZACHARY YOUNG Dentist/Owner 309-207-0112 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Enumeration Date | 2020-01-08 |
Last Update Date | 2020-01-08 |