| NPI | 1174746226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE A MORS President 815-344-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019013887) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |