| NPI | 1790334795 |
|---|---|
| Doing Business As | DENTAL CARE AT IBIS |
| Entity Type | Organization |
| Authorized Contact | JESSICA BRITT Credentialing Coordinator 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2020-03-11 |