NPI | 1720392616 |
---|---|
Doing Business As | MYONTARIODENTIST.COM |
Entity Type | Organization |
Authorized Contact | KENDRA WALKER Credentialing Coordinator 217-540-5100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2010-08-03 |
Last Update Date | 2014-05-09 |