| NPI | 1215126875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERENCE MAH President 217-228-0536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 021002050) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 021002205) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-10-19 |