| NPI | 1215147970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PARKE MAIER President Of Corporation 618-345-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019 015971) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |