| NPI | 1457474637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J MCDILL Dentist 618-398-5770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 19A14624) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |