Individual
MARY K BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3250 N WOODFORD ST, DECATUR, IL 62526-2836
(217) 877-1742
Mailing address
3250 N WOODFORD ST, DECATUR, IL 62526-2836
(217) 877-1742
(217) 877-2222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027977
IL
Other
Enumeration date
06/18/2009
Last updated
08/09/2023
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