NPI | 1497140008 |
---|---|
Doing Business As | QUAIL HOLLOW FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | KIM WILSON Cred Supervisor 217-540-5170 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist General Practice |
Enumeration Date | 2015-03-31 |
Last Update Date | 2015-03-31 |