NPI | 1962883926 |
---|---|
Doing Business As | FAMILIA DENTAL |
Entity Type | Organization |
Authorized Contact | BRANDON ALEXANDER TAYLOR Credentialing & Payer Relations Man 847-453-7396 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2015-06-16 |
Last Update Date | 2021-06-25 |