| NPI | 1760033807 |
|---|---|
| Doing Business As | DENTAL CARE OF EDMONDS |
| Entity Type | Organization |
| Authorized Contact | TABATHA LEMKE Credentialing Coordinator 217-540-6078 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2020-11-20 |