| NPI | 1700398864 |
|---|---|
| Doing Business As | PRICE CREEK DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JESSICA BRITT Credentialing COO Rdinator 217-540-8426 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2017-10-30 |