| NPI | 1700100930 |
|---|---|
| Doing Business As | SHILOH FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | AMANDA HENDERSON Owner 618-288-6201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019025159) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2013-05-14 |