| NPI | 1124280706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD K BURDEN President 618-222-1722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 19-13956) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2008-06-25 |