NPI | 1811309057 |
---|---|
Doing Business As | PLAZA HEALTH DENTISTRY |
Entity Type | Organization |
Authorized Contact | KENDRA WALKER Credentialing Team Lead 217-540-8513 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2014-05-22 |
Last Update Date | 2018-04-25 |