| NPI | 1013280445 |
|---|---|
| Doing Business As | KOALA CENTER FOR SLEEP DISORDERS |
| Entity Type | Organization |
| Authorized Contact | JAMES TODD GRAY Owner/Dentist 309-319-6568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019021753) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2016-04-27 |