NPI | 1417152059 |
---|---|
Entity Type | Organization |
Authorized Contact | EDWARD J PAVLIK President 815-464-6465 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2007-06-15 |
Last Update Date | 2007-07-13 |