| NPI | 1821219023 |
|---|---|
| Doing Business As | BLACKMAN FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | AMY KROEGER Ins COO D 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2014-09-17 |