| NPI | 1326323122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEF DOCTOR President 815-469-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019020721) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2011-10-13 |