NPI | 1902126774 |
---|---|
Doing Business As | FAMILIA DENTAL |
Entity Type | Organization |
Authorized Contact | BRANDON ALEXANDER TAYLOR Credentialing &Payer Relations Mana 847-453-7396 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 22535) |
Enumeration Date | 2010-06-03 |
Last Update Date | 2021-06-25 |