| NPI | 1689145609 |
|---|---|
| Doing Business As | CENTENNIAL COMPLETE DENTAL |
| Entity Type | Organization |
| Authorized Contact | KENDRA WALKER Enrollment Team Lead 217-540-8513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-17 |