| NPI | 1265954598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KENDALL Dentist 309-755-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060.012083) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2022-07-21 |