| NPI | 1851136378 |
|---|---|
| Doing Business As | ULTIMATE DENTAL STUDIO |
| Entity Type | Organization |
| Authorized Contact | HILLARY THULL Credentialing Coordinator 217-540-8946 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2024-06-27 |