| NPI | 1730822479 |
|---|---|
| Doing Business As | WOODLAKE ORTHODONTICS ANOKA |
| Entity Type | Organization |
| Authorized Contact | CELIA HAYES Credentialing COO Rdinator 217-540-8905 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2023-03-28 |