NPI | 1851526693 |
---|---|
Doing Business As | DEER CREEK FAMILY DENTAL CARE |
Entity Type | Organization |
Authorized Contact | KIM WILSON Insurance/Credentialing 217-540-5100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2009-05-22 |
Last Update Date | 2012-11-13 |