| NPI | 1356517247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERRY K. TUNEBERG Dentist/Owner 815-399-0866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 19018462) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-05-01 |