| NPI | 1710985759 |
|---|---|
| Former Legal Business Name | DRS DORAN CAPODICE EFAW & OCHELTREE LLC |
| Entity Type | Organization |
| Authorized Contact | KYNDRA BATA Office Manager 309-663-2526 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 174400000X Specialist |
| 204E00000X Oral & Maxillofacial Surgery | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2023-12-20 |