| NPI | 1629345251 |
|---|---|
| Doing Business As | WALDORF ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | KENDRA WALKER Credentialing Coordinator 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2015-07-18 |