| NPI | 1417216870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMIL M. VERBAN Owner 309-662-8448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019015656) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2012-05-04 |