| NPI | 1720171564 |
|---|---|
| Doing Business As | MESA RIDGE DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | BRITTANY N HOWARD Cred Coordinator 217-540-8946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 270) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2018-11-16 |