| NPI | 1215157797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS J. COLLINS Owner 815-758-3666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019-018261) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2008-10-13 |