Orthodontic Associates Of Columbia And Waterloo

NPI 1295153641 - Dentist - 1223X0400X

NPI Details
NPI 1295153641
Enumeration Date 04/02/2014
Last Updated 04/02/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name BRENT DEE BRENT
Position DR.
Phone (618) 281-3399
Fax
Practice Location
1060 ADMIRAL WEINEL BLVD
COLUMBIA IL, 62236-1988, US
Phone (618) 281-3399
Fax
Business Location
1060 ADMIRAL WEINEL BLVD
COLUMBIA IL, 62236-1988, US
Phone (618) 281-3399
Fax
Toxanomy
Taxonomy Code 1223X0400X
License State Illinois
License Number 019025290
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According to our database, Orthodontic Associates Of Columbia And Waterloo NPI is 1295153641, taxonomy code is 1223X0400X and license number is 019025290, license state is located at Illinois. Orthodontic Associates Of Columbia And Waterloo physically located at 1060 Admiral Weinel Blvd, Columbia IL, 62236-1988. NPI Number 1033115704 has the healthcare provider type.

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1295153641 NPI number is provided on an as is basis without warranty of any kind. 1295153641 is maintained by the National Plan & Provider Enumeration System. The contents of Orthodontic Associates Of Columbia And Waterloo are for informational purposes only.