NPI | 1639815434 |
---|---|
Doing Business As | WOODLAKE ORTHODONTICS RICHFIELD |
Entity Type | Organization |
Authorized Contact | CELIA HAYES Credentialing Coordinator 217-540-2100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2022-05-05 |
Last Update Date | 2022-05-05 |