| NPI | 1427349216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD D RIGGINS Owner 309-797-2001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025287) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019017034) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2011-04-27 |