NPI | 1528752508 |
---|---|
Doing Business As | IMPERIAL DENTAL |
Entity Type | Organization |
Authorized Contact | COURTNEY MONTEITH Credentialing Coordinator 217-540-8306 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2023-06-05 |
Last Update Date | 2023-06-05 |