| NPI | 1740400282 |
|---|---|
| Doing Business As | HERITAGE DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KENDRA WALKER Credentialing Team Lead 217-540-8513 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2024-05-20 |