| NPI | 1689816068 |
|---|---|
| Doing Business As | WINTER GARDEN VILLAGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | PAM HARDIEK Insurance/Credentialing 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2009-03-31 |