| NPI | 1437329968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE L HALL Office Manager 618-667-6650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025572) |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2008-03-12 |