| NPI | 1265946081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR H ESCOBAR President 217-366-1246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021.002026) |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2017-12-01 |