NPI | 1568882066 |
---|---|
Doing Business As | MY DENTIST-MIDTOWN ORTHODONTICS |
Entity Type | Organization |
Authorized Contact | HANNAH FISH Credentialing Coordinator 217-540-5699 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2014-04-23 |
Last Update Date | 2016-04-27 |