| NPI | 1023323623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GUILBEAULT Dentist 618-692-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025281) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2010-08-09 |