NPI | 1780127605 |
---|---|
Doing Business As | CAMINO REAL DENTAL |
Entity Type | Organization |
Authorized Contact | CASSANDRA TEUTSCH Credentialing Coordinator 217-540-8972 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2016-11-25 |
Last Update Date | 2016-11-25 |