| NPI | 1275703175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS E STANDLEY Owner/Operator 217-355-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 023924) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-03-06 |