| NPI | 1427116854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY EARL WILLEY CEO 309-243-7702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2022-07-21 |