NPI | 1790446508 |
---|---|
Doing Business As | AMERICAN FAMILY DENTISTRY - KIRBY QUINCE |
Entity Type | Organization |
Authorized Contact | CELIA HAYES Credentialing Coordinator 217-540-2100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2022-01-04 |
Last Update Date | 2023-06-28 |