| NPI | 1861911893 |
|---|---|
| Doing Business As | NOLL DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | JASON JONES CFO 217-788-2300 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2017-09-11 |