NPI | 1750701660 |
---|---|
Doing Business As | LIFETIME DENTISTRY OF CHICKASHA |
Entity Type | Organization |
Authorized Contact | HANNAH FISH Credentialing Coordinator 217-540-5699 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2014-04-17 |
Last Update Date | 2016-04-27 |