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1841449329
CENTRAL ILLINOIS ORAL AND MAXIOFACIAL SURGERY, PC
SPRINGFIELD, IL
NPI
1841449329
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Entity Type
Organization
Authorized Contact
PAM HARDIEK
Insurance/Credentialing
217-540-5100
Organization Subpart ?
Yes
Primary Taxonomy
1223G0001X Dentist General Practice
Enumeration Date
2008-09-09
Last Update Date
2008-09-11
Business Address
CENTRAL ILLINOIS ORAL AND MAXIOFACIAL SURGERY, PC
2633 CHATHAM RD STE A
SPRINGFIELD, IL 62704-4185
Phone number: 217-698-8777
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Mailing Address
CENTRAL ILLINOIS ORAL AND MAXIOFACIAL SURGERY, PC
2633 CHATHAM RD STE A
SPRINGFIELD, IL 62704-4185
Phone number: 217-698-8777
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