| NPI | 1356356125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH G. KUNNEL President Owner 815-223-0204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019-024293) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |