| NPI | 1730484106 |
|---|---|
| Doing Business As | KOKOPELLI FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CARMEN WOODS Insurance COO Rdinator 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2011-01-17 |
| Last Update Date | 2014-02-04 |