NPI | 1700278959 |
---|---|
Doing Business As | HICKORY CREEK FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | LINDSAY BEARDEN Credentialing Coordinator 217-540-5699 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2015-02-25 |
Last Update Date | 2015-02-27 |