| NPI | 1518418680 |
|---|---|
| Doing Business As | REGAL VALLEY 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 | 2016-10-24 |
| Last Update Date | 2017-01-09 |