| NPI | 1578892915 |
|---|---|
| Doing Business As | CANE RIDGE DENTIST |
| Entity Type | Organization |
| Authorized Contact | ALL CRED Insurance/Credentialing 217-540-2100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2022-10-17 |