NPI | 1396164398 |
---|---|
Entity Type | Organization |
Authorized Contact | NATHANIEL BLAKE SWAAR Vice President 309-661-8900 |
Organization Subpart ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 019028814) |
Enumeration Date | 2014-04-08 |
Last Update Date | 2014-04-08 |