| NPI | 1558781419 |
|---|---|
| Doing Business As | QUIVIRA DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | LORI EDMONDS Credentialing COO Rdinator 217-540-8468 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2016-09-02 |