| NPI | 1821715186 |
|---|---|
| Doing Business As | DEVINE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CEMYIRA MCDOUGAL Credentialing Coordinator 217-764-8609 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2022-10-26 |