| NPI | 1457536732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE R FLYNN Owner 309-346-5140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 00-001854) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2025-05-14 |