| NPI | 1497281745 |
|---|---|
| Doing Business As | SPRING RIDGE DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | KENDRA WALKER Credentialing Supervisor 217-821-7249 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2017-05-05 |