| NPI | 1629351200 |
|---|---|
| Doing Business As | SUMMIT FAIR DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | KENDRA WALKER Credentialing COO Rdinator 217-540-8513 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2018-04-26 |