| 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 |