| NPI | 1447491972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JOSEPH RUBIS President 815-741-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IL 019-016447) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2009-03-12 |