NPI | 1669793790 |
---|---|
Doing Business As | TOMOKA FAMLY DENTISTRY |
Entity Type | Organization |
Authorized Contact | PAM HARDIEK Insurance / Credentialing 217-540-5100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2010-06-11 |
Last Update Date | 2010-06-11 |