NPI | 1669120259 |
---|---|
Doing Business As | DEERWOOD ORTHODONTICS BAYSHORE |
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 | 2022-03-14 |
Last Update Date | 2022-03-14 |