| NPI | 1346452448 |
|---|---|
| Doing Business As | 21ST CENTURY ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | AMY KROEGER Ins COO D 217-540-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |