NPI | 1801323548 |
---|---|
Doing Business As | BONITA ESTERO DENTAL GROUP |
Entity Type | Organization |
Authorized Contact | CASSANDRA NICHOLE TEUTSCH Credentialing Coordinator 217-994-6957 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2017-05-12 |
Last Update Date | 2017-05-12 |