NPI | 1720629603 |
---|---|
Doing Business As | PINE ISLAND ROAD DENTAL CARE |
Entity Type | Organization |
Authorized Contact | JESSICA BRITT Credentialing Coordinator 217-540-5100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2019-10-02 |
Last Update Date | 2019-12-14 |