| NPI | 1770796047 |
|---|---|
| Doing Business As | 21ST CENTURY DENTAL - SPRINGFIELD |
| Entity Type | Organization |
| Authorized Contact | LINDSAY BEARDEN Ins Cood 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2014-01-07 |