| NPI | 1972165207 |
|---|---|
| Doing Business As | DENTAL CARE OF BONAIRE |
| Entity Type | Organization |
| Authorized Contact | JESSICA BRITT Credentialing Coordinator 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2019-08-08 |