| NPI | 1457657744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY DARR President/CEO 888-502-7339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025281) |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2022-01-04 |