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Organization
TANYA L DESANTO, DDS
Active
Organization
TANYA L DESANTO, DDS
Active
Other names
Prairie Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBIN HAYES (OFFICE MANAGER)
(217) 546-0412
Entity
Organization
Contact information
Practice address
2900 GREENBRIAR DR, SPRINGFIELD, IL 62704-6418
(217) 546-0412
(217) 546-0919
Mailing address
2900 GREENBRIAR DR, SPRINGFIELD, IL 62704-6418
(217) 546-0412
(217) 546-0919
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/08/2022
Last updated
10/04/2022
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