NPI | 1548557002 |
---|---|
Doing Business As | FAMILY DENTISTRY OF YUKON |
Entity Type | Organization |
Authorized Contact | HEATHER N. PRUEMER Credentialing Coordinator 217-540-8434 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2011-07-06 |
Last Update Date | 2015-09-15 |