| NPI | 1942967112 |
|---|---|
| Doing Business As | FOUNTAIN HILLS FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JULI RENEE MIETZNER Manager 217-540-5651 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2021-11-23 |