| NPI | 1609548817 |
|---|---|
| Doing Business As | CAROL STREAM DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | BETH KOHN Credentialing Manager 727-776-9642 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2023-08-17 |