| NPI | 1992214985 |
|---|---|
| Doing Business As | MOUNTAIN CREST DENTAL |
| Entity Type | Organization |
| Authorized Contact | JESSICA BRITT Credentialing Coordinator 217-540-8426 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2022-07-21 |