NPI | 1598037020 |
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Doing Business As | GEMMA TANGLAO DALTON, D.D.S. |
Entity Type | Organization |
Authorized Contact | KIM WILSON Insurance/Credentialing 217-540-5100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2012-01-30 |
Last Update Date | 2012-01-30 |