NPI | 1669558250 |
---|---|
Former Legal Business Name | HOLMES DENTAL ASSOCIATES, PC |
Entity Type | Organization |
Authorized Contact | JULIE LIPIC Office Manager 309-662-0523 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-025505) |
Enumeration Date | 2006-10-27 |
Last Update Date | 2018-01-10 |