| NPI | 1225574775 |
|---|---|
| Other Name | SAH ORAL & MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | DON DANIELS VP 815-966-2084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2018-07-12 |