NPI | 1205245693 |
---|---|
Entity Type | Organization |
Authorized Contact | YUDONG XU President 217-356-3335 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026810) |
Enumeration Date | 2014-08-11 |
Last Update Date | 2020-07-27 |