| NPI | 1780974568 |
|---|---|
| Doing Business As | FAMILIA DENTAL |
| Entity Type | Organization |
| Authorized Contact | BRANDON ALEXANDER TAYLOR Credentialing Payer Relations Mgr 847-453-7396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2021-10-21 |