| NPI | 1649644873 |
|---|---|
| Doing Business As | DENTAL CARE ON EAST MAIN |
| Entity Type | Organization |
| Authorized Contact | KENDRA WALKER Enrollment Team Lead 217-540-8513 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2015-11-27 |
| Last Update Date | 2018-07-17 |