NPI | 1821814021 |
---|---|
Doing Business As | HAVENS DENTAL CARE |
Entity Type | Organization |
Authorized Contact | CEMYIRA MCDOUGAL Credentialing Coordinator 217-764-8609 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2024-12-03 |
Last Update Date | 2024-12-03 |