| NPI | 1720138977 |
|---|---|
| Former Legal Business Name | CAPITAL THREE, LLC |
| Entity Type | Organization |
| Authorized Contact | SHAY L CRAWFORD Office Manager 217-522-4451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2008-07-23 |