| NPI | 1598158081 |
|---|---|
| Doing Business As | DENTAL CARE AT COLUMBUS CROSSING |
| Entity Type | Organization |
| Authorized Contact | KELLI ELLSWORTH Credentialing 217-540-5152 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-03-09 |