NPI | 1558772681 |
---|---|
Doing Business As | SUMMIT PLAZA DENTAL CARE |
Entity Type | Organization |
Authorized Contact | ALLISON VARNER Credentialing Coordinator 217-540-6077 |
Organization Subpart ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: NE 6878) |
Enumeration Date | 2014-05-12 |
Last Update Date | 2014-05-12 |