| NPI | 1417528589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT CORY STITES Insurance Coordinator Decision One 630-869-5857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2023-01-13 |