| NPI | 1699365809 |
|---|---|
| Doing Business As | SMALLTOWN DENTAL WILLOW KNOLLS |
| Entity Type | Organization |
| Authorized Contact | LUKE OVERCASH Operations Manager 309-370-5853 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2021-01-21 |