NPI | 1548607674 |
---|---|
Doing Business As | BLUEBONNET DENTAL CARE - SLIDELL |
Entity Type | Organization |
Authorized Contact | JESSICA BRITT Credentialing Coordinator 217-540-8426 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2013-05-30 |
Last Update Date | 2018-09-13 |