NPI | 1043457476 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN C. BURKE Owner 815-469-7150 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021001977) |
Enumeration Date | 2009-01-07 |
Last Update Date | 2009-01-07 |