| NPI | 1295192144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER K WOOLERY Dentist/Owner 815-399-2542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026188) |
| Enumeration Date | 2016-01-23 |
| Last Update Date | 2016-01-25 |