| NPI | 1740897669 | 
|---|---|
| Doing Business As | DENTAL CARE AT TECHE RIDGE | 
| Entity Type | Organization | 
| Authorized Contact | TABATHA LEMKE Credentialing Coordinator 217-540-6078  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Enumeration Date | 2020-09-24 | 
| Last Update Date | 2020-09-24 |