NPI | 1962098210 |
---|---|
Doing Business As | TYRONE FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | TABATHA LEMKE Credentialing Coordinator 217-540-6078 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2020-12-21 |
Last Update Date | 2020-12-21 |