| NPI | 1053677765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI A RICE President 309-691-1990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060010781) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-04-06 |