NPI | 1568999241 |
---|---|
Doing Business As | FAMILIA DENTAL |
Entity Type | Organization |
Authorized Contact | BRANDON ALEXANDER TAYLOR Credentialing & Payer Relation Mana 847-453-7396 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12011918A) |
Enumeration Date | 2017-05-12 |
Last Update Date | 2021-06-23 |