| NPI | 1811784200 | 
|---|---|
| Doing Business As | PLAZA COLLINA DENTAL CARE | 
| Entity Type | Organization | 
| Authorized Contact | HILLARY THULL Credentialing Coordinator 217-540-8946 | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Enumeration Date | 2025-04-21 | 
| Last Update Date | 2025-04-21 |