| NPI | 1982768974 |
|---|---|
| Doing Business As | SOUTH FARM FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | PAM HARDIEK Ins Cood 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2010-12-13 |