| NPI | 1346475159 |
|---|---|
| Doing Business As | ORAL & MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | JEFFREY LEMAY Pres. Board Of Directors 815-625-4790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2009-05-22 |