| NPI | 1720759103 |
|---|---|
| Doing Business As | CONVERSE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | HANNAH FISH Credentialing Manager 217-540-5699 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2023-11-01 |