| NPI | 1770055360 |
|---|---|
| Doing Business As | ADVANCED DENTISTRY AT WINDHAVEN |
| Entity Type | Organization |
| Authorized Contact | COURTNEY MONTEITH Credentialing Coordinator 217-540-8306 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2023-01-03 |