| NPI | 1982094462 |
|---|---|
| Doing Business As | FAMILIA DENTAL |
| Entity Type | Organization |
| Authorized Contact | BRANDON ALEXANDER TAYLOR Credentialing Payer Relations Mgr 847-453-7396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026920) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2021-06-25 |