| NPI | 1437881224 |
|---|---|
| Doing Business As | LASTING IMPRESSIONS DENTAL LLC |
| Entity Type | Organization |
| Authorized Contact | JAMIE VILK Manager 217-463-4110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2022-07-21 |