NPI | 1649305921 |
---|---|
Doing Business As | TOTAL HEALTH DENTISTRY |
Entity Type | Organization |
Authorized Contact | JACQUELYN LEAH RICHARDSON President Dentist 309-762-3015 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026572) |
Enumeration Date | 2007-02-23 |
Last Update Date | 2008-06-25 |