| NPI | 1992397558 |
|---|---|
| Doing Business As | DENTAL CARE AT SOUTH COMMONS |
| Entity Type | Organization |
| Authorized Contact | CELIA HAYES Credentialing COO Rdinator 217-540-8905 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2023-07-14 |