| NPI | 1326390113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE A MULVANEY Managing Partner 815-398-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019020600) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2012-10-04 |