| NPI | 1376294306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIKA BZDAL Director 815-340-1046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2022-01-11 |